Hyperlipidemias, Xerosis, Depression, Liver Diseases
Conditions
Brief summary
Since abnormal keratinocyte (KC) proliferation and differentiation as well as defective E cadherin expression were reported in vitiligo lesions, the investigators set to study the potential efficacy of combining Retinoids, which are known to improve KC proliferation and differentiation and increase the expression of adhesion molecules, with narrowband UVB in the treatment of vitiligo.
Detailed description
• Twenty patients with generalized vitiligo will be included in this study. All patients will be subjected to: * Clinical evaluation: * An informed written consent. * History taking include age, previous treatment, disease activity * Clinical examination including Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA) * Photography (before starting the treatment and every 2 weeks till the end of the study) Laboratory evaluation: * 2 mm punch skin biopsies will be taken from vitiligo patients, 1 from lesional and the other from perilesional skin before treatment. * The patients will be randomly assigned to two groups: Group A: patients will receive three NB-UVB sessions per week for 48 sessions. Group B: patients will receive three NB-UVB sessions per week for 48 sessions combined with acitretin in a dose of 0.3mg/kg/day daily. * Controls: 20 individuals age and sex matched will be biopsied from the skin of their abdominoplasty surgery. * Another two 2 mm punch skin biopsies will be taken from lesional and perilesional skin at the onset of repigmentation if repigmentation starts before completion of the 48 treatment session or after completion of the treatment period if repigmentation does not occur. * .All biopsies from patients and controls will be stained Immunohistochemically by anti-E cadherin antibody.
Interventions
Patients receive nbUVB session 3 times per week
DRUGAcitretin
The patients will receive the drug and the effect on repigmentation on vitiligo lesions will be observed
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Two groups Group A: patients will receive three NB-UVB sessions per week for 48 sessions. Group B: patients will receive three NB-UVB sessions per week for 48 sessions combined with acitretin in a dose of 0.3 mg/kg/day daily.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients with generalized non-segmental vitiligo (25%-75%) * Males, postmenopausal females and premenopausal females not planning to get pregnant during the period of treatment and after 2 years from the end of treatment. * Age more than 18 years.
Exclusion criteria
* Children ˂ 18 years old * Pregnant females * Premenopausal females planning to get pregnant within the period of treatment or within 2 years after. * Patients receiving treatment for vitiligo within the past 2 months. * Patients with abnormal liver profile * Patients with abnormal lipid profile * Patients with associated photosensitive disorders * Patients having associated skin diseases other than vitiligo * Cataract and aphakia * High cumulative dose from previous sessions of narrowband ˃ 200-300 session
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determining whether addition of acitretin is beneficial for vitiligo patients or not using Vitiligo Area Scoring Index | 4-5 months | The number of patients who will achieve 100%, 75% and 50% repigmentation of vitiligo lesions will be compared between group A (nbUVB) and group B (nbUVB+ acitretin) after 48 nbUVB sessions. The comparison of the 2 groups will be assessed using Vitiligo Area Scoring Index (VASI) |
| Determining whether addition of acitretin is beneficial for vitiligo patients or not using Vitiligo Disease Activity Score. | 4-5 months | The number of patients who will achieve 100%, 75% and 50% repigmentation of vitiligo lesions will be compared between group A (nbUVB) and group B (nbUVB+ acitretin) after 48 nbUVB sessions. The comparison of the 2 groups will be assessed using Vitiligo Disease Activity Score (VIDA). |
Countries
Egypt
Contacts
Primary ContactNoha A. Saleh, M.Sc
Outcome results
None listed