Treatment Guidelines

PUVA For VITILIGO

72hrs-MPD
  1. Starting dose: -0.5-1.0 J/cm2.
  2. Increment:- If No erythema on vitiliginous skin-> Increase 0.5-1.0 J/cm2 /Week
  3. No of Sittings: 2-3/ week.

    4. Follow up :- Gradual increase till light pink colour is induced & maintained.
  • Missed sittings:

    • - 1-2 missed sittings -> previous dose

    - 3 missed sittings -> dose prior to last dose

    - ³ 4 missed sittings -> 40% of last dose.

    - ³ month -> restart from beginning.
  • Adverse Effects:

    • - Mild erythema: same previous dose.

    - Moderate erythema: same previous dose, next sitting -> old dose (If no erythema -> cautious increments).

    - Severe erythema: No treatment sitting (steroids, NSAIDs) & next sitting -> 40-50% of last dose.

    - Itch -> emollient + antihistamine.

    - Facial erythema -> sunscreen.
  • Remarks:

    • -If face &/or hands are affected -> sunsreen or cotton gloves.

    -limit the use of topical steroids plus encourage frequent use of emollients.

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