Evaluation of the therapeutic effect of PUVA therapy in chronic vitiligo patients

Introduction: Vitiligo is an acquired pigmentary disease, characterized by depigmented macules or patches which distracts the psychosocial behaviour of patients. Various therapeutic modalities have been admintered over time with variable outcome. Psoralen followed by irradiation with UV-A (PUVA) is one of the effective treatment methods for chronic vitiligo cases who had failed to react the other treatment methods. Aim: To assess the efficacy of therapeutic effect of oral psoralen followed by ultraviolet-A irradiation (PUVA) therapy for chronic vitiligo cases. Materials and Methods: A total 36 patients of both sexes with acral, acrofacial and generalised vitiligo with more than 20% spread over body, between age group 15-60 years were recruited. 8 MOP tablets are given with empty stomach according to body weight. All cases were undergone to UVA exposure artificial phototherapy chamber starting with a dose of 4 J/m2 (Dosage depends on Fitzpatrick skin type) over whole body after 90 min. Clinical response was evaluated as marked response rate. Results: Generalised vitiligo was seen in 66.6% cases, acral was seen in 16.6% cases, acrofacial was seen in 16.6% cases. Erythema was the common side effect followed by xerosis, pruritus, nausea and vomiting, bulla and burning. The mean duration of treatment was 14.52 months with mean no of sessions is 62.18. Conclusion: PUVA therapy is a well-established treatment modality for vitiligo with very minimal risk of malignancies and has less side effects like erythema and xerosis. PUVA is safe, effective, and cosmetically acceptable. Generalized vitiligo was responded well to the treatment.