Vitiligo Treatment With a Combination of PUVA Therapy and Epidermal Autografts

REPORT OF A CASE  A 20-year-old woman of Indian descent presented with a 6-month history of progressive vitiligo. Small lesions were present on the ventral aspect of the right wrist (diameter, 2 cm); the left popliteal fossa (diameter, 1.5 cm); and adjacent to the right thumbnail (1×0.5 cm). A larger lesion (4×6 cm) was present on the dorsum of the left foot (Figure, left). A routine course of psoralen plus UV-A (PUVA) using oral methoxsalen (0.4 mg/kg) (Oxsoralen Ultra, ICN Pharmaceuticals, Costa Mesa, Calif) and wholebody exposure to UV-A commenced.¹ The initial dose of UV-A radiation was 1.0 J/cm², and this was increased by 0.5 J/cm² in each treatment until a light pink erythema was induced in the areas of vitiligo; subsequent increases were aimed at maintaining this color. Perifollicular repigmentation plus hyperpigmentation of the border was seen in all of the small lesions, commencing at treatment