Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study.
BACKGROUND
The first choice treatment for vitiligo vulgaris is narrow-band UVB (NB-UVB), but no satisfactory treatment exists.


OBJECTIVE
To investigate if Polypodium leucotomos, an antioxidative and immunomodulatory plant extract, improves NB-UVB-induced repigmentation.


METHODS
Fifty patients with vitiligo vulgaris randomly received 250 mg oral P. leucotomos or placebo three times daily, combined with NB-UVB twice weekly for 25-26 weeks.


RESULTS
Repigmentation was higher in the P. leucotomos group vs. placebo in the head and neck area (44% vs. 27%, P = 0.06). Small repigmentation increases (P = n.s.) were observed for the trunk (6% increased repigmentation), extremities (4%), and hands and feet (5%) in the P. leucotomos group vs. placebo. Patients attending more than 80% of required NB-UVB sessions showed increased repigmentation in the head and neck area in the P. leucotomos group vs. placebo (50% vs. 19%, P < 0.002); no significant differences were seen in the other body areas. Patients with skin types 2 and 3 showed more repigmentation in the head and neck area in the P. leucotomos group vs. placebo (47% vs. 21%, P = 0.01), and no significant differences were seen in the other body areas. No conclusions could be drawn on skin types 4 and 5 due to low patient numbers.


CONCLUSIONS
There is a clear trend towards an increase in repigmentation of vitiligo vulgaris affecting the head and neck area when NB-UVB phototherapy is combined with oral P. leucotomos. This effect may be more pronounced in light skin types.
Netherlands Institute for Pigment Disorders, Department of Dermatology, Academic Medical Center, 1100 DD Amsterdam, The Netherlands. m.a.middelkamphup@amc.uva.nl
M A
MA
Middelkamp-Hup
J D
JD
Bos
F
F
Rius-Diaz
S
S
Gonzalez
W
W
Westerhof
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D032494:Polypodium; D011446:Prospective Studies; D012720:Severity of Illness Index; D012880:Skin Pigmentation / Q000187:drug effects / Q000528:radiation effects; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*; D014820:Vitiligo / Q000188:drug therapy* / Q000532:radiotherapy*
D010936:Plant Extracts