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| | ORIGINAL CONTRIBUTIONS | | | | | Year : 1999 | Volume : 65 | Issue : 5 | Page : 219-221 | Topical mometasone furoate for the treatment of childhood vltiligo
BL Masuria, A Batra, RK Kothiwala, R Khuller, Sing
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Correspondence Address:
B L Masuria
PMID: 20921663 Forty-five children with vitiligo were treated with topical applications of mometasone furoate for 2 to 6 months. The best results occurred in the facial vitiligo. Repigmentation of 90-100% was achieved in more than 80% of patients with vitiligo of the face and more than 60% of patients with vitiligo on other part of the body. Interestingly there was no single side effect noted even after six months application in children.
Keywords: Mometasone furoate, Vitiliga, Children
How to cite this article:
Masuria B L, Batra A, Kothiwala R K, Khuller R, Sing. Topical mometasone furoate for the treatment of childhood vltiligo. Indian J Dermatol Venereol Leprol 1999;65:219-21 |
How to cite this URL:
Masuria B L, Batra A, Kothiwala R K, Khuller R, Sing. Topical mometasone furoate for the treatment of childhood vltiligo. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2014 Mar 7];65:219-21. Available from: http://www.ijdvl.com/text.asp?1999/65/5/219/4816 |
| Introduction | |  |
Vitiligo is a common idiopathic acquired heritable melanocytopenic depigmentation disorder. The disorder results in substantial cosmetic disfigurement, particularly in dark-skinned patients. Even limited vitiligo in such an individual is socially detrimental. It appears to be a common condition with general incidence reported to be one percent.[1] In recent years, several studies have indicated that the topical applications of corticosteroid preparations may promote repigmentation in the lesions of vitiligo.[1-4] Mometasone furoate is a non fluorinated topical corticosteroid with high potency and safety profile.[5] This study was designed to evaluate the efficacy as well as safety profile of mometasone furoate in childhood vitiligo.
| Materials and Methods | | |
Forty-five children with stable vitiligo were selected. Cases of post inflammatory hypopigmentation were not included. The age range [Table - 1] of the patients was from 2-14 years. Total number of the depigmented patches, their size and sites were recorded. History of the vitiligo was obtained with special references to family history, duration of disease, spread of disease and treatment taken previously. A complete physical as well as systemic examination and basic investigations like complete haemogram and blood sugar estimation were carried out at the commencement of therapy. The areas of vitiligo were photographed before treatment was initiated and at various times during the course of therapy.
Patients were advised to apply mometasone furoate 0.1% ointment once a day for six months or till complete repigmentation whichever was earlier. Patients were followed up at monthly intervals. They were carefully observed for any cutaneous, ocular or systemic side effects.
Complete repigmentation in this study meant the repigmentation of more than 90% of the total area of the tested patches of vitiligo and partial pigmentation meant beginning of perifollicular and marginal erythema and pigmentation.
| Results | | |
The first sign of response to treatment was the appearance of perifollicular islands of pigmentation in the areas of vitiligo. These islands of repigmentation gradually coalesced. In addition, there was a gradual spread of pigment from the margins of the vitiligo patches into the amelanotic areas. The first evidence of repigmentation in most lesions was seen one to four months after the start of treatment.
Twenty-five patients were treated for vitiligo of face. Six of them responded with complete repigmentation after 2 months of treatment, whereas 8 required 4 months and 8 required 6 months to achieve the same result while 3 showed only partial repigmentations after 6 months of treatment.
Eleven patients with vitiligo of trunk were treated. Three responded with successful repigmentation after 4 months of treatment whereas 4 required 6 months to achieve the complete repigmentation. Two did not show any repigmentation with 6 months of treatment and 2 showed only partial repigmentation after six months of treatment.
Eighteen patients were treated for vitiligo of extremities, of which 5 achieved complete repigmentation after 4 months of treatment, whereas 6 required six months to achieve same result. Two did not show any repigmentation while 5 showed partial repigmentation after 6 months of therapy. The results of the treatment of vitiligo on different parts of body with durations of treatment are given in [Table - 2].
Partial repigmentation achieved in 3 patients with facial vitiligo, 2 patients with vitiligo of trunk continued to improve for one to two months even after treatment was terminated. Three of five partial repigmented patients with vitiligo of extremities relapsed during one year follow up study.
| Discussion | | |
Our study revealed complete improvement in 88% of facial vitiligo, 63% of vitiligo of trunk and 61% of vitiligo of extremities after 6 months therapy without any local or systemic side effects. Similar results have been reported in another study where clobetasol propionate was used.[1] The clobetasol propionate and betamethasone -17-valerate have been used in different concentrations with varying success rates by many workers. [4, 6, 7] These strong corticosteroids have their own limitations for long and continuous use especially in children with larger areas, because of their topical as well as systemic side effects, whereas mometasone furoate being a strong yet safe corticosteroid can be used for longer duration in children.
The mechanism of the beneficial effects of costicosteroids in cases of vitiligo remains uncertain. The finding of an increased incidence of autoantibodies in patients with vitiligo,[8] suggests a possible autoimmune basis for the disease. Topical steroids may locally suppress the immunologic changes allowing inactive melanocytes to repopulate affected skin sites.[1]
Differences in skin physiology especially permeability, at different anatomic sites might explain the higher success rate in cases of vitiligo on the face as has been reported.[1] Melanocytic density of facial skin is also higher than skin of trunk and limbs. Thus, larger number of residual melanocytes in unaffected facial skin may further explain the better results of repigmentation on the face. The results of this study indicate that a strong non fluorinated steroid, mometasone furoate, is a useful agent for treatment of childhood vitiligo without any local or systemic side effects.
| Acknowledgement | | |
We are thankful to Fulford India for their help in carrying out this study and providing mometasone furoate.
| References | | |
| 1. | Janak Kumari. Vitiligo treated with topical clobetasol propionate. Arch Dermatol 1984;120:631-635.  | | 2. | Kandil E. Vitiligo: Response to 0.2% betamethasone 17 valerate in flexible collodion. Dermalologica 1970;141:271-281. [PUBMED] [FULLTEXT] | | 3. | Koopman-van drop B, Goedhart-van Dijk B, Neering H, et al. The treatment of vitiligo by local application of betamethasone-17 valerate in a dimethyl sulfoxide cream base. Dermatologica. 1973;146:310-314. | | 4. | Kandil E. Treatment of vitiligo with 0.1% betamethasone-17-valerate in isopropyl alcohol: A double blind trial. Br J Dermatol 1974;91:457-460. [PUBMED] [FULLTEXT] | | 5. | Panja SK, Morwah A, Sharma SD. Double-blind comparison of mometasone furoate 0.1% and betamethasone valerate 0.12% cream in dermatosis. Indian J Dermatol 1991;36:21-27. | | 6. | Bleehen SS. The treatment of vitiligo with topical corticosteroids. Br J Dermatol 1976;94 (suppl 12):4-50. [PUBMED] [FULLTEXT] | | 7. | Clayton A. A double blind trial of 0.05% clobetasol propionate in the treatment of vitiligo. Br J Dermatol 1977;96:71-73. | | 8. | Brostoff J, Bor S, Feiwel M. Autoantibodies in patients with vitiligo. Lancet 1969;2:177-178. |
Tables [Table - 1], [Table - 2] |
