title: Left-right comparison study of the combination of fluticasone propionate and UV-A vs. either fluticasone propionate or UV-A alone for the long-term treatment of vitiligo.
abstract: OBJECTIVE
  To compare the efficacy and safety of using a combination of fluticasone propionate (FP) and UV-A with that of either drug used alone in the long-term treatment of vitiligo.
  
  
  METHODS
  Prospective, randomized, controlled, left-right comparison study. Repigmentation was judged by a single dermatologist (L.N.-K.) and skin thickness was scored by a pathologist (using biopsy samples), a dermatologist (L.N.-K.) (visually), and patients (using a standard questionnaire).
  
  
  METHODS
  Netherlands Institute for Pigmentary Disorders, Amsterdam.
  
  
  METHODS
  Patients with lesions on arms, legs, and trunk were treated on 2 symmetrical lesions for 9 months with FP alone and a combination of FP and UV-A (FP group) or with UV-A alone and a combination of FP and UV-A (UV-A group). Fluticasone propionate cream was applied once daily at about bedtime, and UV-A (10 J/cm2) exposure was twice a week. Patients attended the clinic at 3-month intervals.
  
  
  RESULTS
  One hundred thirty-five patients were included, 96 of whom were evaluable after 9 months. Patients not reaching the end point withdrew because of insufficient repigmentation (n = 23), decreased motivation (n = 11), or protocol violations (n = 5). No patient (irrespective of whether they withdrew) experienced any adverse effects. The FP and UV-A groups were comparable with respect to sex, age, and location of lesions. On average, combination treatment was 3 times more effective than either UV-A or FP treatment alone. In the FP group, no atrophy was seen after 9 months with either treatment. In the UV-A group, a little atrophy was detected twice: as well during UV-A treatment alone as during combination treatment.
  
  
  CONCLUSIONS
  Combination treatment with FP and UV-A is much more effective in reaching complete repigmentation than are FP and UV-A used alone, but large inter-individual differences occur. Fluticasone propionate, UV-A, and a combination of FP and UV-A seem to be safe for long-term treatment of vitiligo.
authors.affiliation: The Netherlands Institute for Pigmentary Disorder, Amsterdam. w.westerhof@amcuva.nl
authors.forename: W
authors.initials: W
authors.lastname: Westerhof
authors.forename: L
authors.initials: L
authors.lastname: Nieuweboer-Krobotova
authors.forename: P G
authors.initials: PG
authors.lastname: Mulder
authors.forename: E J
authors.initials: EJ
authors.lastname: Glazenburg
mesh_terms: D000293:Adolescent; D000328:Adult; D000730:Androstadienes / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012880:Skin Pigmentation / Q000187:drug effects / Q000528:radiation effects; D013997:Time Factors; D014467:Ultraviolet Therapy; D014820:Vitiligo / Q000628:therapy*
chemical_list: D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D000068298:Fluticasone