1-alpha-24-dihydroxyvitamin-d3 and Facial-Dermatoses

The treatment of vitiligo is still one of the most difficult dermatological challenges, although there are many therapeutic options. Narrow band ultraviolet B (NB-UVB) phototherapy is considered to be a very important modality for generalized vitiligo.. The aim of this study was to explore whether a combination of NB-UVB and topical agents would be superior to NB-UVB alone for treating vitiligo.. We searched the electronic databases such as PUBMED, EMBASE, Cochrane Library, and Web of Science. The primary outcome was the proportion of ≥50% repigmentation (a clinical significance), and secondary outcome was the proportion of ≥75% repigmentation (an excellent response).. Seven randomized controlled trials (RCTs) involving 240 patients (413 lesions) were included in this meta-analysis. The study showed no significant difference between NB-UVB combination therapy (NB-UVB and topical calcineurin inhibitor or vitamin D analogs) and NB-UVB monotherapy in the outcomes of ≥50% repigmentation and ≥75% repigmentation. However, lesions located on the face and neck had better results in ≥50% repigmentation (RR = 1.40, 95% CI 1.08-1.81) and ≥75% repigmentation (RR = 1.88, 95% CI 1.10-3.20) with NB-UVB and topical calcineurin inhibitor combination therapy vs. NB-UVB monotherapy.. The meta-analysis suggested that adding neither topical calcineurin inhibitors nor topical vitamin-D3 analogs on NB-UVB can yield significantly superior outcomes than NB-UVB monotherapy for treatment of vitiligo. However, addition of topical calcineurin inhibitors to NB-UVB may increase treatment outcomes in vitiligo affecting face and neck.

Topics: Administration, Cutaneous; Calcineurin Inhibitors; Calcitriol; Chemoradiotherapy; Dermatologic Agents; Dihydroxycholecalciferols; Facial Dermatoses; Humans; Neck; Randomized Controlled Trials as Topic; Skin Pigmentation; Tacrolimus; Ultraviolet Therapy; Vitamin D; Vitiligo

Facial psoriasis gives rise to considerable concern because of associated cosmetic problems and psychosocial distress. It requires a treatment approach other than topical corticosteroids, which bear a risk of cutaneous adverse reactions. Recently, topical tacalcitol has been shown to be effective in psoriasis.. The aim of this open-label single-centre study is to investigate the efficacy and safety of high-concentration (20 μg g⁻¹) ) tacalcitol ointment (Bonalfa-high(®) , Teijin Pharma, Tokyo, Japan) in patients with facial psoriasis and to evaluate clinical response according to the distribution of facial psoriatic lesions.. Thirty-seven patients were enrolled to this clinical trial. Tacalcitol 20 μg g⁻¹ ointment was applied once daily to psoriatic lesions of the face over an 8-week period. Patients were also categorized into three subtypes according to facial lesion distribution. Efficacy was evaluated by the facial Psoriasis Area and Severity Index (facial PASI) and the Physician's Global Assessment (PGA) score at weeks 2, 4 and 8. The Subjective Global Assessment (SGA) was also determined at the end of the study.. Thirty-three patients completed the clinical trial. Mean facial PASI of 33 patients at baseline was 9·58 and after 8 weeks of treatment the mean facial PASI decreased significantly to 3·88. By using PGA, patients showed the following responses to treatment: clearance (n = 1); excellent (6); good (16); fair (4); slight (5); no change (1). The response rate among the three facial psoriasis types showed no difference. Using the SGA, 27 (82%) of the patients presented excellent (15%) or good (67%) effect with tacalcitol 20 μg g⁻¹ ointment. No serious adverse reactions were observed.. This is the first clinical study reporting a relevant therapeutic effect and favourable safety profile of tacalcitol 20 μg g⁻¹ ointment in facial psoriasis. These results suggest that tacalcitol 20 μg g⁻¹ ointment can be used as the first-line treatment in patients with facial psoriasis.

Topics: Adult; Aged; Dermatologic Agents; Dihydroxycholecalciferols; Facial Dermatoses; Female; Humans; Male; Middle Aged; Ointments; Prospective Studies; Psoriasis; Severity of Illness Index; Young Adult

Topics: Administration, Topical; Adolescent; Child; Dermatologic Agents; Dihydroxycholecalciferols; Facial Dermatoses; Female; Humans; Male; Melanosis; Ointments; Treatment Outcome; Young Adult