To evaluate the response to oral
psoralen ultraviolet-A (PUVA)
photochemotherapy in patients with
vitiligo in Taiwan, we retrospectively reviewed the clinical data of 21
vitiligo patients treated from 1990 to 1998. Diagnosis included generalized
vitiligo in 16 patients, focal
vitiligo in three, and acrofacial
vitiligo in two. All patients were treated two to three times per week over a period of 3 to 19 months with 0.2 to 0.4 mg/kg of
trioxsalen 2 hours before exposure to long-wave ultraviolet light irradiation. The results for
PUVA therapy showed 10 patients (48%) had an excellent response (75-100% repigmentation), four (19%) had a good response (50-75% repigmentation), one had a moderate response (25-50% repigmentation), and six (29%) had a poor response (0-25% repigmentation). Despite the high rate of satisfactory outcomes, the response to
PUVA therapy with respect to specific localization revealed poor response in eight out of 10 patients with
vitiligo on the hands and feet. Acute adverse effects of PUVA included
pruritus in eight patients xerosis in one patient, and burning with blistering in four patients.
Long-term adverse effects such as
actinic keratosis and
skin cancer were not found within the follow-up period, which ranged from 2 months to 7 years. Our findings indicate that long-term oral PUVA with
trioxsalen is an effective treatment for
vitiligo in Taiwanese patients.