HomeDermatologyDermatology NewsVitiligo Suggested Early Systemic Glucocorticoid Treatment

Vitiligo Suggested Early Systemic Glucocorticoid Treatment

A team of investigators led by Fuquan Lin, MD, Department of Dermatology, Third People’s Hospital of Hangzhou, Hangzhou, China, recommended that early systemic glucocorticoid treatment be carried out on patients with vitiligo.

The treatment was particularly recommended for patients with excessive VIDA scores, predisposing components, and special clinical markers.

A total of 272 progressive vitiligo patients with Vitiligo disease activity (VIDA) scores ≥ 2 points and skin lesion area < 1% of body floor surface area were included in the study, all of whom acquired no systemic glucocorticoid treatment.

Data were collected from the Department of Dermatology at the Third People′s Hospital of Hangzhou from June 2018 to June 2019.


Related

Vitiligo linked to insomnia risk


The team analyzed the realm and kind of skin lesions, VIDA scores, predisposing factors, and special clinical markers similar to trichrome vitiligo, confetti-like depigmentation, Koebner phenomenon, and inflammatory vitiligo.

From there, patients were randomly divided into 3 groups: the random quantity desk topical glucocorticoid group (62), oral prednisone and topical glucocorticoid group (76), compound betamethasone injection, and topical glucocorticoid group (134 ).

The last 2 groups were known as the systemic and topical glucocorticoid groups.

Patients in the topical glucocorticoid group were treated with halometasone cream or 0.05% clobetasol propionate cream once a day.

For patients handled with the oral prednisone treatment, doses were adjusted once every 7 days, and step by step decreased from 30 mg/d to twenty, 15, 10, and 5 mg/d. The treatment lasted 35 days.

In the course of the treatment with compound betamethasone injection, the intramuscular injection was carried out once every 20 days at a dose of 1 ml for two sessions.

The secure disease price was calculated in these groups after 3 months of treatment and was outlined since the proportion of patients experienced no development in the course of the study among the analyzed patients.

Changes in vitiligo sorts were evaluated after 1 year of follow-up and statistical analysis was carried out through the use of the Kruskal-Wallis H test, χ2 test, and Fisher′s exact test.

The team reported an important distinction in the enlargement price of skin lesion area among the 3 groups ( H = 12.468, P < 0.001) after 3 months of treatment.

Likewise, the enlargement rate of skin lesion area was considerably decreased in the oral prednisone and topical glucocorticoid group and the compound betamethasone injection and topical glucocorticoid group than in the topical glucocorticoid group ( P < 0.001, = 0.005, respectively, α = 0.016 7).

Among the patients with slowly progressive vitiligo, (VIDA scores = 2 or 3 points), investigators noted that the secure disease price was considerably increased in the systemic and topical glucocorticoid group than in the topical glucocorticoid group ( χ2 = 23.973, 11.877, respectively, each P < 0.001).

The stable disease price additionally differed among the patients with completely different VIDA scores in the systemic and topical glucocorticoid group ( χ2 = 17.122, P < 0.001).

Patients with predisposing components or particular clinical markers confirmed considerably decreased stable disease price (47.3% [35/74], 41.2% [47/114], respectively) in contrast with those without predisposing components or particular scientific markers (70.6% [96/136], 87.5% [84/96]; χ2 = 11.098, 47.548, respectively, each P < 0.001) after 3 months of treatment.

After 1 year of follow-up, the proportion of patients with localized vitiligo transformed into non-localized vitiligo was considerably increased within the topical glucocorticoid group (41.9%, 26/62) than in the systemic and topical glucocorticoid group (21.9%, 46/210; χ2 = 10.328, P = 0.006),

Moreover, the proportion of patients with localized vitiligo transformed into non-localized vitiligo increased within the group with predisposing components or particular scientific markers than in that without predisposing components or particular scientific markers.

“Early systemic glucocorticoid therapy needs to be carried out within the progressive vitiligo patients with excessive VIDA scores, predisposing components, and special clinic markers,” the group wrote.

The research, “Efficacy of systemic glucocorticoid therapy and its associated components in patients with progressive vitiligo,” was printed online within the Chinese language Journal of Dermatology.

Source

Must Read
Related News