TOPICAL PHOTOCHEMOTHERAPY OF VITILIGO WITH A NEW KHELLIN FORMULATION - PRELIMINARY CLINICAL-RESULTS

The benefits of using topical photochemotherapy for the treatment of v itiligo are the avoidance of systemic effects and a reduction in carci nogenic potential, but it can produce severe phototoxic reactions, Sin ce khellin has phototherapeutic properties similar to those of the pso ralens without the phototoxic effects and without the formation of det ectable DNA mutations, it has been used in the treatment of vitiligo w ith controversial results. The aim of this study was to evaluate the e fficacy of a novel gel formulation of khellin, based upon a water/ 2-p ropanol/propylene glycol (WPG) ternary system, in the topical photothe rapy of vitiligo. A total of 36 patients suffering from different type s of vitiligo underwent a 6-month period of treatment. A 1% gel formul ation of WPG and khellin was applied to one side of the body and as a control only the WPG vehicle to the other side, 30 min before UVA expo sure. The khellin-WPG preparation showed increased solubility with enh anced patient compliance. Repigmentation (>10% of the initially affect ed area) occurred in 86.1% of the khellin-WPG-treated sides vs 66.6% o f the placebo-treated sides (P < 0.01). Young patients with a short du ration of disease demonstrated a better response. Our results indicate that treatment with topical khellin-WPG gel preparation combined with UVA significantly improves the clinical outcome of patients with viti ligo by facilitating the availability of the drug in the skin.