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Oral dexamethasone pulse treatment for vitiligo
S Radakovic-Fijan1, A M Fürnsinn-Friedl, H Hönigsmann
1Divisions of Special and Environmental Dermatology and General Dermatology, Department of Dermatology, University of Vienna Medical School, Austria. s.radakovic@akh-wien.ac.at
Journal of the American Academy of Dermatology
|April 20, 2001
Summary
Oral dexamethasone pulse therapy effectively halts vitiligo progression in Austrian patients. However, it shows limited repigmentation and commonly causes mild to moderate side effects, without suppressing cortisol long-term.
Area of Science:
- Dermatology
- Endocrinology
- Pharmacology
Background:
- Oral corticosteroid pulse therapy for vitiligo yields variable outcomes.
- Previous studies on Indian populations showed inconsistent results.
Purpose of the Study:
- To assess the efficacy, safety, and tolerability of oral dexamethasone pulse therapy.
- To evaluate this treatment in a cohort of Austrian vitiligo patients.
Main Methods:
- 29 vitiligo patients (25 progressive, 4 stable) received weekly oral dexamethasone pulses (10 mg for 2 days).
- Treatment duration was up to 24 weeks, with monthly evaluations of response and side effects.
- Hormonal levels (cortisol, corticotropin) were monitored in a subset of patients.
Main Results:
- Disease progression halted in 88% of active vitiligo cases.
- Repigmentation was minimal (marked in 6.9%, moderate/slight in 10.3% each).
- Side effects occurred in 69% of patients; hormonal levels normalized between pulses.
Conclusions:
- Oral dexamethasone pulse therapy is effective in arresting vitiligo progression.
- It does not induce significant repigmentation in most patients.
- Mild to moderate side effects are frequent, but sustained cortisol suppression is not observed.