Familial coexisting and colocalized psoriasis and vitiligo responding to alefacept.
BACKGROUND
Psoriasis is an immune-mediated, chronic, inflammatory disease that significantly impairs both physical and emotional aspects of an individual's quality of life. Vitiligo leads to depigmentation of skin, in which some or all melanocytes in the interfollicular epidermis and occasionally those in the hair follicles are selectively destroyed. The coexistence of the two disorders is rarely seen.


OBJECTIVE
To report two cases of the rare coexistence of psoriasis and vitiligo in a family.


METHODS
After providing informed written consent, both patients were given alefacept 15 mg/kg weekly injections for 12 weeks. The patients were monitored both clinically and with all relevant laboratory investigations. These patients were then followed up once a month for 2 years.


RESULTS
Treatment with alefacept led to complete clearance of vitiligo along with the expected improvement in psoriasis. In the 2-year follow-up, vitiligo did not recur, although psoriasis relapsed and was appropriately treated.


CONCLUSIONS
Use of alefacept in vitiligo may turn out to be a possible novel off-label treatment option in vitiligo. But the results need to be reproduced in larger studies.
Department of Dermatology, Farwaniya Hospital, Farwaniya, Kuwait. nalmut@usa.net
Nawaf
N
Al-Mutairi
Azari
A
Al-Doukhi
D000293:Adolescent; D000077944:Alefacept; D001706:Biopsy; D003879:Dermatologic Agents / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012867:Skin / Q000473:pathology*; D013997:Time Factors; D014820:Vitiligo / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology
D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept