Is The Glycerol, Petroleum Jelly and Liquid Paraffin Mixture (Dexeryl®) an Adjunctive Therapy for Vitiligo of Autoimmune Origin? Toward a Novel Therapeutic Indication. About a Case

Abstract

Introduction: Vitiligo, considered to have an autoimmune basis, is an acquired, non-contagious disorder characterized by progressive, patchy loss of pigmentation from skin, overlying hair, and oral mucosa. The treatment of vitiligo includes medicines or medicated skin creams, such as corticosteroids or a calcineurin inhibitor, phototherapy, Depigmentation, or removing color from dark areas, surgical techniques. The results from treatments can vary from one part of the body to another, and new patches may appear in the meantime Here, we report a case with complete remission of vitiligo of autoimmune origin under DMARDs and the glycerol, petroleum jelly and liquid paraffin mixture (dexeryl®), of which we hypothesize that the glycerol, petroleum jelly and liquid paraffin mixture (dexeryl®) would have played a role in rapid and complete vitiligo lesion regression. Clinical Observation: An 18-year-old Malian female presented to the internal medicine outpatient clinic with 3-months history of pruritic achromic skin patches. Concomitantly, this was associated with Gottron's papules, polyarthralgia with arthritis and exertional dyspnea for which the diagnosis of mixed connective tissue disease (MTCD) based on the EULAR/ACR 2019 criteria for systemic lupus erythematosus, EULAR/ACR 2010 criteria for rheumatoid arthritis with subcutaneous rheumatoid nodule, EULAR/ ACR 2013 criteria for systemic scleroderma, Bohan and Peter 1975 criteria for probable dermato-polymyositis and Kasukawa’s criteria 1988 for MTCD itself; and autoimmune hemolytic anemia (AHA) with positivity of the direct coombs test and the context of hemolysis were made. Vitiligo of autoimmune origin was considered because of the clinical context and the immunological disorder in this case. She was treated only with Disease-Modifying Anti-rheumatic Drugs (DMARDs) and glycerol, petroleum jelly and liquid paraffin mixture (dexeryl®). The vitiligo lesion had completely resolved on 1-year follow-up visit in our case without specific vitiligo treatment. Discussion: The glycerol, petroleum jelly and liquid paraffin mixture (dexeryl®) in our case was indicated for dry skin presentation. But we observed a rapid and complete vitiligo regression under this mixture associated with DMARDs. This is why, beside a controlled inflammation process by DMARDs, we suspected a role of glycerol, petroleum jelly and liquid paraffin mixture (dexeryl®) in melanocyte regeneration. Conclusion: This case would highlight a potential novel indication of glycerol, petroleum jelly and liquid paraffin mixtures (dexeryl®) in vitiligo of autoimmune origin. A clinical trial will be necessary to deeply appreciation this novel therapeutic property of glycerol, petroleum jelly and liquid paraffin mixtures (dexeryl®).