Systemic immunomodulatory effects of Polypodium leucotomos as an adjuvant to PUVA therapy in generalized vitiligo: A pilot study.

Although extensive research has been done to improve the treatment of vitiligo, an universal effective treatment for vitiligo is not yet available [1]. PUVA therapy has demonstrated to have immunomodulatory effects, mainly in the T lymphocyte compartment but has several adverse effects, such as skin cancer risk [2,3]. The optimization of PUVA therapy is a relevant clinical objective in the management of vitiligo patients. Polypodium leucotomos (PL) extract has demonstrated to have relevant photoprotective effects in humans [4,5] and animal models [6]. These biological effects may be involved in the action mechanism of PL on vitiligo patients, and could explain the enhancement of the pigmentary response of conventional PUVA by PL when this was used as adjuvant treatment in vitiligo patients [4]. In order to optimize PUVA treatment for management of vitiligo patients, we therefore investigated potential immunomodulatory effects of PUVA associated with PL. For this purpose, a pilot randomized, double-blind, placebo-controlled, clinical trial designed to study effects of PUVA + PL on T lymphocytes from 19 generalized vitiligo patients was conducted (Table 1). At baseline (before first PUVA session) and after 12 weeks of treatment (before of the last PUVA session), peripheral blood both from patients and from each corresponding control was withdrawn. Repigmentation response was evaluated