Treatment of vitiligo with local khellin and UVA: comparison with systemic PUVA.

Vitiligo is an idiopathic leukoderma often with a progressive course causing destruction of melanocytes. The best methods for achieving cosmetically acceptable re-pigmentation of affected skin appear to be both local and systemic PUVA. They may, however, cause serious side effects, which is an argument for conducting research into new, equally effective photo-chemotherapeutic agents. One of these agents is khellin. We conducted a pilot study in 33 patients to evaluate the effectiveness of local KUVA and systemic PUVA therapy for vitiligo and to compare them in terms of the degree of re-pigmentation, duration of treatment, number of procedures, total UVA dose and side effects. Local KUVA required longer duration of treatment and higher UVA doses. KUVA-induced re-pigmentation depended on the age of the patients (r = -0.61, P = 0.001), and better results were achieved with younger individuals [% re-pigmentation = 81.76 - (1.48 x age in years)]. No side effects were observed in cases of local KUVA treatment. Erythema, itching and gastro-intestinal disturbances occurred with some patients treated with PUVA. The results demonstrate that local KUVA may effectively induce re-pigmentation of vitiligo-affected skin areas to a degree comparable to that achieved when using systemic PUVA, provided that treatment duration is long enough.

Influence of T-actemodulin on herpes simplex virus infection.

The aim of the investigation was to study the direct influence of T-actemodulin (TAM) on the Herpes Simplex Virus (HSV) infection in vitro and in vivo. HSV-1 (strain Vic) and HSV-2 (strain Nissa) were used in the experiments in vitro. The experiments were performed using multicycle and singlecycle growth tests. Seventy-five patients suffering from HSV infections (labialis and genitalis) were locally treated by 0.04% TAM-containing hydrophilic gel or water-washable cream (applied every 3 h). The results showed that TAM: decreased the infectious virus titre; reduced the infectious virus yield at the end of the single cycle of the virus replication; prolonged the latent period; and exerted an irreversible inhibitory effect on the infectious virus titre when applied at immediate early intervals after the infection. No relapses were observed in 84% of the patients treated with TAM. Eight percent of the patients were with only reduced relapses and in 8% of the patients TAM had a mild effect. TAM exerted a preventive effect against the disease when the treatment was initiated in the period of paresthesia.