Psoralen photochemotherapy (PUVA) is only moderately effective in widespread vitiligo: a 10-year retrospective study

被引:30
作者
Kwok, YKC
Anstey, AV
Hawk, JLM [1 ]
机构
[1] St Thomas Hosp, St Johns Inst Dermatol, Dept Environm Dermatol, PHotobiol Unit, London SE1 7EH, England
[2] Cardiff Univ, Cardiff CF4 4XN, S Glam, Wales
关键词
D O I
10.1046/j.1365-2230.2002.00984.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
A 10-year retrospective analysis of the use of psoralen photochemotherapy (PUVA) in the treatment of vitiligo was undertaken at the St John's Institute of Dermatology, London, UK. Of 97 patients included in this study, eight had complete or almost complete repigmentation, 59 moderate to extensive repigmentation, and 30 showed little or no response. However, 24 of those who had responded to PUVA with extensive repigmentation did not consider their response satisfactory because of persistence of vitiligo at cosmetically sensitive sites, and poorly matching, speckled repigmentation. Fifty-seven patients who initially improved with PUVA therapy subsequently relapsed, in most cases within a year of stopping treatment. Relapses in 22 patients were on the same cutaneous sites as previously affected, while vitiligo at new sites developed in 20 patients and both new and old sites were affected in a further 15 patients. Patients who retained their pigmentation after 2 years appeared to have a better chance of permanent remission. The only statistically significant prognostic indicator of relapse was patient age at the start of treatment, younger patients tending to retain their pigmentation longer than older patients. This study emphasizes the need for careful patient counselling before PUVA therapy as this treatment seldom achieves extensive repigmentation that is cosmetically acceptable, and treatment response is often followed by relapse.
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页码:104 / 110
页数:7
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