Evaluation of safety and efficacy of topical prostaglandin E2 in treatment of vitiligo.
BACKGROUND
Prostaglandin E2 (PGE2) has stimulant and immunomodulatory effects on melanocytes and regulates their proliferation.


OBJECTIVE
To study the efficacy and safety of topical PGE2 in treating stable vitiligo patches involving <5% body surface area.


METHODS
Fifty-six consecutive patients with clinically diagnosed stable vitiligo of types vulgaris, focal, segmental, lip and genital applied a translucent PGE2 (0.25 mg g(-1)) gel twice daily for 6 months. Evaluation was fortnightly for 3 months and monthly thereafter up to 6 months. Assessment was based on degree of repigmentation in treated patches ranging from 0% (no change) to 100% (complete repigmentation). Overall response was graded as: poor, 1-25% repigmentation; moderate, 26-50%; good, 51-75%; excellent, >75%.


RESULTS
Vitiligo vulgaris was the most common type (n=22; 39%), followed by focal and lip vitiligo, with lesions being mostly on the face (25%) and lips. Repigmentation was seen in 40 of 56 patients (71%), with mean onset at 2 months. Patients with disease duration of 6 months or less repigmented best, with face and scalp responding earliest (1-1.5 months). Complete clearance occurred in eight of 40 patients, six of the eight having face lesions. Excellent response was seen in 22 of 40 patients. All neck, scalp and trunk lesions, 33% genital, 29% lip vitiligo, 100% segmental and 63% focal patches showed moderate to excellent response. Incidence of side-effects was 18%, mainly a transient burning sensation especially on the lips.


CONCLUSIONS
The efficacy and safety of topical PGE2 make it a promising therapy for localized stable vitiligo.
Kapoor
R
R
Department of Dermatology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Mumbai 400022, India. drrinkyk31@yahoo.com
Phiske
M M
MM
Jerajani
H R
HR
D000279:Administration, Cutaneous; D000328:Adult; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015232:Dinoprostone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy*; D055815:Young Adult
D003879:Dermatologic Agents; D015232:Dinoprostone