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Treatment of vitiligo vulgaris with narrow-band UVB and oral Polypodium leucotomos extract: a randomized double-blind placebo-controlled study.

  • 2007-04-18
  • Journal of the European Academy of Dermatology and Venereology : JEADV 21(7)
    • M A Middelkamp-Hup
    • J D Bos
    • F Rius-Diaz
    • S Gonzalez
    • W Westerhof

Study Design

Type
Randomized Controlled Trial (RCT)
Population
50 patients with vitiligo vulgaris
Methods
randomly received 250 mg oral P. leucotomos or placebo three times daily, combined with NB-UVB twice weekly for 25-26 weeks
Blinding
Double-blind
Duration
25-26 weeks
Funding
Unclear

Background

The first choice treatment for vitiligo vulgaris is narrow-band UVB (NB-UVB), but no satisfactory treatment exists.

Objectives

To investigate if Polypodium leucotomos, an antioxidative and immunomodulatory plant extract, improves NB-UVB-induced repigmentation.

Methods

Fifty patients with vitiligo vulgaris randomly received 250 mg oral P. leucotomos or placebo three times daily, combined with NB-UVB twice weekly for 25-26 weeks.

Results

Repigmentation was higher in the P. leucotomos group vs. placebo in the head and neck area (44% vs. 27%, P = 0.06). Small repigmentation increases (P = n.s.) were observed for the trunk (6% increased repigmentation), extremities (4%), and hands and feet (5%) in the P. leucotomos group vs. placebo. Patients attending more than 80% of required NB-UVB sessions showed increased repigmentation in the head and neck area in the P. leucotomos group vs. placebo (50% vs. 19%, P < 0.002); no significant differences were seen in the other body areas. Patients with skin types 2 and 3 showed more repigmentation in the head and neck area in the P. leucotomos group vs. placebo (47% vs. 21%, P = 0.01), and no significant differences were seen in the other body areas. No conclusions could be drawn on skin types 4 and 5 due to low patient numbers.

Conclusion

There is a clear trend towards an increase in repigmentation of vitiligo vulgaris affecting the head and neck area when NB-UVB phototherapy is combined with oral P. leucotomos. This effect may be more pronounced in light skin types.

Research Insights

  • Polypodium Leucotomos→Improved Repigmentation

    Small repigmentation increases (P = n.s.) were observed for the trunk (6% increased repigmentation), extremities (4%), and hands and feet (5%) in the P. leucotomos group vs. placebo.

    Effect
    Neutral
    Effect size
    Small
    Dose
    250 mg three times daily
  • Polypodium Leucotomos→Improved Skin Pigmentation

    Repigmentation was higher in the P. leucotomos group vs. placebo in the head and neck area (44% vs. 27%, P = 0.06).

    Effect
    Neutral
    Effect size
    Small
    Dose
    250 mg three times daily
  • Polypodium Leucotomos→Improved Skin Repigmentation

    Patients with skin types 2 and 3 showed more repigmentation in the head and neck area in the P. leucotomos group vs. placebo (47% vs. 21%, P = 0.01)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    250 mg three times daily
  • Polypodium Leucotomos→Increased Repigmentation

    Patients attending more than 80% of required NB-UVB sessions showed increased repigmentation in the head and neck area in the P. leucotomos group vs. placebo (50% vs. 19%, P < 0.002)

    Effect
    Beneficial
    Effect size
    Large
    Dose
    250 mg three times daily
  • Polypodium Leucotomos→Increased Repigmentation of Trunk

    Small repigmentation increases (P = n.s.) were observed for the trunk (6% increased repigmentation) in the P. leucotomos group vs. placebo.

    Effect
    Neutral
    Effect size
    Small
    Dose
    250 mg three times daily
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