The efficacy of low-dose oral corticosteroids in the treatment of vitiligo patients.
BACKGROUND
One of the most probable pathogeneses of vitiligo is autoimmunity. Systemic corticosteroids suppress immunity and may arrest the progression of vitiligo and lead to repigmentation. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients.


METHODS
Eighty-one patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg body weight) initially for 2 months; the dosage was then reduced to half of the initial dose for the third month and was halved again for the fourth and final month. The effects of treatment were evaluated using photographs of before and after the study. Side-effects were assessed at the first, second, third and fourth month of treatment.


RESULTS
Arrested progression of vitiligo and repigmentation were noted in 87.7% and 70.4% of patients respectively. Male sex, a patient age of 15 years or under, and a duration of disease of 2 years or less showed increased repigmentation with statistical significance. The side-effects of treatment were minimal and did not affect the course of treatment.


CONCLUSIONS
Low-dose oral corticosteroids are effective without serious side-effects in preventing the progression and inducing repigmentation of actively spreading vitiligo, which is difficult to treat with topical corticosteroids or photochemotherapy.
Kim
S M
SM
Department of Dermatology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Suwon, South Korea.
Lee
H S
HS
Hann
S K
SK
D015746:Abdominal Pain / Q000139:chemically induced; D000152:Acne Vulgaris / Q000139:chemically induced; D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000473:pathology; D012880:Skin Pigmentation / Q000187:drug effects; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D011239:Prednisolone