ABSTRACT
BACKGROUND: It is mandatory to measure the minimal phototoxic dose(MPD) in order to determine adequate irradiation of UV-A in photochemotherapy. However, the measurement of MPD is not easy in some cases due to inadequte size and site of lesions, time and manpower. OBJECTIVE: The purspose of this study was to standardize the minimal phototoxic dose for a vitiliginous lesion. METHODS: The minimal phototoxic dose of UV-A was measured in 82 vitiligo patients. Then we analyzed the MPD according to the sex, age, site of the vitiliginous lesions, duration of disease, and administration route of the photosensitizer. RESULTS: 1. There were no significant differences between exposed and unexposed areas in MPD in both cases of topical and systemic administration of the photosensitiser. 2. There was no significant correlation between disease duration and MPD in both cases of topical and systemic administration of the photosensitiser. 3. In the group of topical application of 8-methoxypsoralen cream, MPD for males and females were 0.53+0.38J/cm2 and 0.48+0.32J/cm2 respectively without significant difference in sex. 4. In the group of systemic administration of 8-methoxypsoralen, there was a significant difference between males and females in MPD. The MPD in males and females were 1.38+0.72J/cm2 and 2.51 + 1.40J/cm2, respectively. 5. In the group of topical application of 8-methoxypsoralen cream, the MPD in 2nd decade patients was the highest(0.80+0.55J/cm2). The MPD had a tendency to decrease gradually as age receded from the 2nd decade. 6. In the group of systemic administration of 8-methoxypsoralen, there was a tendency for the MPD to be increased according to age without statistical significance. 7. MPD in the group systemically administrated with 8-methoxypsoaralen was four-fold to that of the topical application group. CONCLUSION: It may be valuable to keep in mind that there was a statistical differrence in MPD between sexes in systemic administration of the photosensitizer, and that MPD was different according to patients age in the topical application group.
Subject(s)
Female , Humans , Male , Methoxsalen , Photochemotherapy , Skin , VitiligoABSTRACT
BACKGROUND: Vitiligo is an acquired depigmentary disorder characterized by loss of melanocytes from the epidermis. Autografting using the suction blistered epidermis technique is one of the surgical modalities of vitiligo treatment, and has been successfully used by several authots. OBJECTIVE: The purpose of this study was to evaluate the effect of the autografting using the suction blistered epidermis technique for the treatment of vitiligo. METHODS: 142 sites from 39 patients with vitiligo were treated with autografting using the suction blistered epidermis technique. The recipient sites were prepared by freezing with liquid nitrogen of the sites 48 hours prior to grafting. RESULTS: Better results were seen in cases with the following Factors: a) cases where the disease had been present for more than 3 years b) the post-operative period had been Longer than a year c) the Lesional sites of the vitiligo were on the trunk and neck rather than the neck and extremities d) the vitiligo had affected the grabous rather than the hairy areas on the face. However, there were no differences between the clinical types(such as generalized, localized, and segmental) in the success rate of treatment. Preopera'tive PUVA or post operative PUVA also did not affect the statistical results. CONCLUSION: On autografting using the suction blistered epidermis, it is better to select the patients who have had the disease for more than 3 years, and graft the epidermis which has increased melanocytes by preoperative PUVA for good treatment results and even pigmentation.