The efficacy of low-dose oral corticosteroids in the treatment of vitiligopatients

Background One of the most probable pathogeneses of vitiligo is autoimmunit y. Systemic corticosteroids suppress immunity and may arrest the progressio n of vitiligo and lead to repigmentation. The clinical efficacy of low-dose oral corticosteroids was assessed to minimize the side-effects in actively spreading vitiligo patients. Methods Eighty-one patients with vitiligo were evaluated. The patients took daily doses of oral prednisolone (0.3 mg/kg body weight) initially for 2 m onths; the dosage was then reduced to half of the initial dose for the thir d month and was halved again for the fourth and final month. The effects of treatment were evaluated using photographs of before and after the study. Side-effects were assessed at the first, second, third and fourth month of treatment. Results Arrested progression of vitiligo and repigmentation were noted in 8 7.7% and 70.4% of patients respectively. Male sex,a patient age of 15 years or under, and a duration of disease of 2 years or less showed increased re pigmentation with statistical significance. The side-effects of treatment w ere minimal and did not affect the course of treatment. Conclusions Low-dose oral corticosteroids are effective without serious sid e-effects in preventing the progression and. inducing repigmentation of act ively spreading vitiligo, which is difficult to treat with topical corticos teroids or photochemotherapy.