Photochemotherapy with Topical Khellin and Sunlight in Vitiligo

Orecchia, G.; Perfetti, L.

doi:10.1159/000247517

Cited by 54 publications

(34 citation statements)

References 6 publications

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“…Although psoralens with exposure to solar radiation (PUVAsol) or to UVA radiation from an artificial source (PUVA) are not the magic bullet for the therapy of vitiligo, they are still being used as a chemotherapeutic agent against vitiligo on a major scale to date. Variable results have been reported with a new photochemotherapeutic regimen using khellin, a furanochromone, as photosensitizer together with UVA radiation [1]. Similar results have been reported with oral and topical phenylalanine with UVA exposure [2, 3].…”

Section: Introductionmentioning

confidence: 64%

Combination of PUVAsol and Topical Calcipotriol in Vitiligo

Parsad¹,

Saini²,

Verma³

1998

Dermatology

122

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Background: A large variety of therapeutic agents are being tried for the treatment of vitiligo, but psoralens continue to be mainstay of treatment although they are not uniformly effective. Recent advances in pathophysiology have established a perturbed calcium homeostasis in affected skin, and melanocytes were shown to express vitamin D₃ receptors. Objective: The purpose of present study was to determine the efficacy of the combination of PUVAsol with topical calcipotriol in the treatment of vitiligo. Methods: Nineteen patients with essentially bilateral symmetrical lesions were enrolled in a randomized, double-blind, right/left comparative study of 18 months duration. An oral dose of 0.6 mg/kg 8-methoxypsoralen was given 2 h before exposure to sunlight thrice weekly to all patients. The patients were advised to apply calcipotriol (50 μg/g) on one side of the body and placebo ointment over the lesions on the other side twice daily. Results: At the end of 6 months, 12 patients (70%) showed marked to complete improvement on calcipotriol-treated sides as compared to 6 patients (35%) showing similar improvement on placebo-treated sides (p <0.05). At the end of treatment, 13 patients (76%) showed marked improvement in calcipotriol-treated lesions whereas 9 patients (53%) showed moderate to marked improvement in placebo-treated lesions. The repigmentation of hands and feet was much better with the combination of PUVAsol and calcipotriol. Conclusion: The combination of PUVA and calcipotriol is highly effective and works faster and may be used for shortening the therapy with PUVA in the treatment of vitiligo.

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Section: Introductionmentioning

confidence: 64%

Combination of PUVAsol and Topical Calcipotriol in Vitiligo

Parsad¹,

Saini²,

Verma³

1998

Dermatology

122

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“…A lefteright placebo controlled study of topical khellin with natural sunlight found no benefit over placebo. 104 However, when taken orally in combination with natural light exposure, 16% of patients achieved repigmentation of more than 90%, with a response rate of more than 75%, while controls showed none. 105 Other studies showed repigmentation rates of 70% or more in 41% of patients, a response comparable to treatment with psoralens.…”

Section: Khellinmentioning

confidence: 98%

Vitiligo: A comprehensive overview

Felsten

Alikhan

Petronic‐Rosic

2011

Journal of the American Academy of Dermatology

154

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“…2 More detailed studies of khellin's properties confirm that it has several advantages compared with the classical psoralens -it is less photo-toxic and carcinogenic, does not pigment the healthy skin, its systemic use does not cause significant side effects typical for the psoralens 1 and it could be combined with solar irradiation without risks of phototoxic incidents. 5 This could be explained by the fact that Orecchia and Perfetti used the sun as their source of UVA (1 h sun exposure ¼ 4-5 J ⁄ cm 2 UVA). There were no patients with no re-pigmentation.…”

Section: Reportmentioning

confidence: 99%

Treatment of vitiligo with local khellin and UVA: comparison with systemic PUVA

2004

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Vitiligo is an idiopathic leukoderma often with a progressive course causing destruction of melanocytes. The best methods for achieving cosmetically acceptable re-pigmentation of affected skin appear to be both local and systemic PUVA. They may, however, cause serious side effects, which is an argument for conducting research into new, equally effective photo-chemotherapeutic agents. One of these agents is khellin. We conducted a pilot study in 33 patients to evaluate the effectiveness of local KUVA and systemic PUVA therapy for vitiligo and to compare them in terms of the degree of re-pigmentation, duration of treatment, number of procedures, total UVA dose and side effects. Local KUVA required longer duration of treatment and higher UVA doses. KUVA-induced re-pigmentation depended on the age of the patients (r = -0.61, P = 0.001), and better results were achieved with younger individuals [% re-pigmentation = 81.76 - (1.48 x age in years)]. No side effects were observed in cases of local KUVA treatment. Erythema, itching and gastro-intestinal disturbances occurred with some patients treated with PUVA. The results demonstrate that local KUVA may effectively induce re-pigmentation of vitiligo-affected skin areas to a degree comparable to that achieved when using systemic PUVA, provided that treatment duration is long enough.

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Photochemotherapy with Topical Khellin and Sunlight in Vitiligo

Cited by 54 publications

References 6 publications

Combination of PUVAsol and Topical Calcipotriol in Vitiligo

Combination of PUVAsol and Topical Calcipotriol in Vitiligo

Vitiligo: A comprehensive overview

Treatment of vitiligo with local khellin and UVA: comparison with systemic PUVA

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