Comparison of efficacy and side-effect profile of oral PUVA vs. oral PUVA sol in the treatment of vitiligo: a 36-week prospective study.
BACKGROUND
Both Oral PUVA and PUVA sol have been successfully used in vitiligo treatment. However, there is paucity of studies comparing the two therapies, especially under subtropical conditions of abundant sunlight where PUVA sol is more feasible.


OBJECTIVE
To compare the efficacy and side effects of oral PUVA versus oral PUVA sol therapy in generalized vitiligo.


METHODS
Comparative prospective clinical trial conducted on consecutive patients of generalized vitiligo. Response to treatment was assessed using change in Lund & Browder (L & B) score for assessment of reduction in body surface area of involvement, patient global assessment (PGA) of improvement in vitiligo, investigator's global assessment (IGA) of extent of repigmentation, and quality of life (QOL) assessment using Tjioe et al questionnaire.


RESULTS
Thirty five patients were recruited- 18 in PUVA and 17 in PUVA sol group. Mean percentage change in L & B score at 36 weeks was 46.4% in PUVA and 26.1% in PUVA sol group (P = 0.06), mean PGA score in PUVA was 4.58 ± 2.23 and in PUVA sol group was 6 ± 2.08 (P = 0.13), mean IGA score was 3.08 ± 1.68 in PUVA and 1.79 ± 0.57 in PUVA sol group (P = 0.11). QOL scores were significantly higher in PUVA group as compared to the PUVA sol group (P = 0.04). Side effects were comparable in two groups except for phototoxic side effects which were significantly more in PUVA group.


CONCLUSIONS
PUVA is more efficacious than PUVA sol and also provides greater psychological benefit in treatment of generalized vitiligo but is associated with more phototoxic adverse effects.
Department of Dermatology & Venerology, All India Institute of Medical Sciences, New Delhi, India.
S
S
Singh
S
S
Khandpur
V K
VK
Sharma
M
M
Ramam
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008730:Methoxsalen / Q000627:therapeutic use; D008875:Middle Aged; D011701:PUVA Therapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014820:Vitiligo / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult
D017319:Photosensitizing Agents; D008730:Methoxsalen