Efficacy and safety of topical or oral methoxsalen plus ultraviolet A in the treatment of vitiligo

Vitiligo is a common skin disorder that presents as depigmented patchs and associated with psychosocial morbidity. Photochemotherapy with methoxsalen plus ultraviolet A (PUVA) is an effective and commonly used modality in treatment of vitiligo and is available in Khorasan Province since more than ten years ago. This uncontrolled clinical trial included patients with vitiligo referred to phototherapy center in Emam Reza Hospital in Mashhad during 1998-1999. Treatment was done topically on patients with involvement less than 2% of the body area and systemic in cases with involvement more than that. Data including improvement rate and side effects were analyzed by SPSS software version 11.5. One-hundred and thirty-five patients, 79 female and 56 male, were enrolled. One-hundred and twenty-six patients were treated systemically and 9 patients underwent topical therapy. Complete (100%) repigmentation was observed in one patient. Repigmentation of 80-99%, 60-79%, 40-59%, 20-39% and less than 20% were observed in 53, 43, 12, 6 and 20 patients; respectively. Results were significantly better in generalized vitiligo, face involvement, and cases whom recieved more than 200 treatment sessions, but there was not significant relationship between improvement and patient's age, family history, the first involved area, beginning time of repigmentation, the observed interval between initiation of treatment and disorder appearance, and skin type. Common side effects were pruritus (69.6%), erythema (52.6%), nausea and vomiting (28.9%), and headache (17.8%). PUVA therapy is an effective and safe treatment in patients with vitiligo, and has good results in nonsegmental vitiligo and facial involvement.