Experience with calcipotriol as adjunctive treatment for vitiligo in patients who do not respond to PUVA alone: A preliminary study

Background: PUVA therapy remains a primary treatment for vitiligo, despite unsatisfactory results. Because of calcipotriol's reported effects on melan ocytes and on immunomodulatory and inflammatory mediators we wondered wheth er adding calcipotriol to PUVA would be more effective than PUVA alone in t reating vitiligo. Objective: We sought to determine whether the combination of topical calcip otriol and PUVA therapy increases the responsiveness of patients with vitil igo refractory to PUVA alone. Methods: Twenty-one patients with vitiligo refractory to previous PUVA ther apy were studied. Patients received 60 sessions of PUVA 3 times a week and 0.005% topical calcipotriol twice daily. Patients were monitored for repigm entation overall and on the trunk, extremities, and acral regions. Results: Starting at the median of the 17th treatment session, some degree of repigmentation was observed in 71.5% of the patients. After treatment, c osmetically acceptable overall repigmentation was observed in 29% of patien ts; repigmentation of lesions on the trunk, extremities, and acral region w as noted in 36%, 58%, and 0% of patients, respectively Adverse reactions we re mild and tolerable. Conclusion: The combination of PUVA and calcipotriol may be effective thera py and should be further investigated for the treatment of vitiligo.