Treatment responses in patients with vitiligo to very potent topical corticosteroids combined with vitaminotherapy in Madagascar

Abstract

Vitiligo is a refractory disease in which treatment modalities are not yet established. We aim to assess results obtained 10years after the initiation ofa therapeutic protocol which combines very potent topical corticosteroids (TCS), vitaminotherapy (B12 and C), and suppression of microtraumas in the management of nonsegmental vitiligo in Madagascar. It was a prospective and descriptive study over a period of 6years (2011-2016) in the Department of Dermatology, Joseph Raseta Befelatanana, Antananarivo, Madagascar. The diagnosis of vitiligo was based on clinical data. Patients who agreed to follow the treatment protocol, which combined very potent TCS (two applications/day for 10days, and then one application/day for the following 10days), oral vitamin C 500mg/day for 20days, and oral vitamin B12 100mg/day for 20days, were included in the study. Two successive courses of treatment were made 10days apart. The details of 308 vitiligo patients were analyzed. The mean age of patients was 33.3years. There was a female preponderance (sex ratio: 0.6). The duration of treatment in our patients varied from 3 to 18months. Two hundred and thirty-nine patients had good therapeutic compliance and attended regular follow-up. Excellent repigmentation (more than 76% area repigmented) was noted in 50 patients (65.7%) less than 14yearsof age. Lesions evolving inless than 1year in 31 patients (36.9%) had excellent response to treatment. Localized lesions responded favorably to treatment with excellent repigmentation in 108 patients. These results show that therapeutic response is better in young people, lesions less than 1year of evolution, and for localization of vitiligo in the face and neck.