Photochemotherapy of Vitiligo with Oral Trioxsalen and Tropical Sunlight.

Abstract

Six black adults suffering from widespread symmetrical vitiligo (5 with and I without associated autoimmune disease) of 2 to 10 years duration were treated for 18 months on alternate days with orally administered trioxsalen, 10mg. followed 2 hours later by 30 minutes lesion-exposure to tropical midday sunlight Whereas all lesions became intensely but transiently pruritic and erythematous immediately after each treatment session, repigmentation started in 4 weeks (Le. after several treatment sessions) from normal skin at periphery of lesions and around bait follicles within lesions as pin-bead-sized black macules which enlarged Slowly and eventually coalesced to obliterate the white patches. Lesions overlying soft tissue and muscle bulk pigmented well while those over bony prominences failed to pigment satisfactorily. Re-pigmented areas have remained stable and cosmetically acceptable for up to 5 years. Two patients complained of burning sensation after each treatment but were able to complete the treatment Response to above treatment with over 75% (in 4 patients) and 50% (in 2 patients) repigmentation of originally diseased skin without significant side effects led to the conclusion that photochemotherapy utilizing trioxsalen and sunlight was effective against widespread vitiligo in dark-skinned patients in the tropics