From basic research to the bedside: efficacy of topical treatment with pseudocatalase PC-KUS in 71 children with vitiligo.
BACKGROUND
The epidermal accumulation of hydrogen peroxide (H(2)O(2)) has been documented in vitiligo.


OBJECTIVE
To assess the effect on disease cessation and repigmentation of the reduction/removal of H(2)O(2) using low-dose, narrow-band, ultraviolet-B (UV-B)-activated pseudocatalase PC-KUS in 71 children with vitiligo.


METHODS
This uncontrolled and retrospective study included 45 girls and 26 boys (mean age, 10.3 years) who applied topical PC-KUS twice daily to the entire body surface without narrow-band UV-B dose increments. The affected body areas were documented by special photography at the first visit and after 8-12 months. The response was evaluated by two independent physicians as > 75% vs. < 75% total repigmentation of the face/neck, trunk, extremities, and hands/feet. Generalized (n = 61) and segmental (n = 10) vitiligo were evaluated as different entities. The effect of total-body, low-dose, narrow-band UV-B (0.15 mJ/cm(2)) monotherapy once daily without any increments and without application of PC-KUS was tested over 6 months in 10 children with vitiligo vulgaris (mean age, 8.4 years).


RESULTS
One hundred per cent cessation was observed in 70 of the 71 children. More than 75% repigmentation was achieved in 66 of 71 patients on the face/neck, 48 of 61 on the trunk, and 40 of 55 on the extremities; however, repigmentation on the hands/feet was disappointing (five of 53). The response was independent of skin color, age of onset, duration of disease, other demographic features, and previous treatments. The follow-up after narrow-band UV-B monotherapy showed no significant repigmentation in all areas. Seven of 10 patients showed progression of their vitiligo.


CONCLUSIONS
A reduction in epidermal H(2)O(2) using low-dose, narrow-band UV-B-activated pseudocatalase PC-KUS is an effective treatment for childhood vitiligo which can be safely performed at home.
Schallreuter
Karin U
KU
Department of Biomedical Sciences, University of Bradford, Bradford, UK. K.Schallreuter@Bradford.ac.uk
Krüger
Christian
C
Würfel
Brigitte A
BA
Panske
Angela
A
Wood
John M
JM
D000287:Administration, Topical; D000293:Adolescent; D000367:Age Factors; D002374:Catalase / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011701:PUVA Therapy / Q000379:methods*; D012106:Research; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D014820:Vitiligo / Q000175:diagnosis* / Q000188:drug therapy*
C038109:pseudocatalase; D002374:Catalase