Co-supplementation of oral antioxidant to PUVASol therapy has no effect on oxidative stress index in patients of unstable vitiligo: A hospital based pilot study

Gaurav Bhardwaj, Jaspreet Kaur


Background In recent years, interest has grown in studying the role of oxidative stress in vitiligo, so measurement of the combined activities of all antioxidants or the Total antioxidant status (TAS) is often used to estimate the overall antioxidant status. Likewise, Total oxidant status (TOS) is measured to determine a patient’s overall oxidation state. Furthermore, the oxidative stress index (OSI), which is calculated as the ratio of TOS to TAS, may be a more accurate index of oxidative stress in the body. This study was done to measure the effect of oral antioxidant supplementation therapy for 1 month on the oxidative stress index in patients of vitiligo.


Methods In this pilot study 40 consecutive patients presenting in departmental vitiligo clinic were enrolled and randomly allocated into 2 groups of 20 patients each were prescribed oral prednisolone at a dosage of 1mg/kg for 2 consecutive days/week along with oral 8-methoxypsoralen on 3 alternate days in a week at a dose of 0.6mg/kg body weight. Patients in group B received the following antioxidants orally along with treatment of group A. End point of the study was 1 month of continuous therapy in the respective groups. OSI was calculated before initiating treatment by serum collection.


Results The mean OSI decreased significantly in both the study groups individually (P = 0.037 & 0.040 for Group A and B respectively). However inter-group comparison between the 2 study groups showed no statistically significant difference (P = 0.052).


Conclusion Addition of antioxidants to PUVASol in treatment of unstable vitiligo has no effect on oxidative stress index.



Vitiligo, PUVASol, total oxidant status, total antioxidant status, oxidative stress index

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Jain D, Mishra R, Kumar A, and Jaiswal G. Levels of malondialdehyde and antioxidants in the blood of patients with vitiligo of age group 11–20 years. Indian J Physiol Pharmacol. 2008;52:297-301.

Handa S and Kaur I. Vitiligo: Clinical findings in 1436 patients. J Dermatol.1999;26:653-7.

Parsad D, Dogra S, Kanwar AJ, Kumar B. Dermatology life quality index score in vitiligo and its impact on the treatment outcome. Br J Dermatol. 2003;148:373-74.

Pahwa P, Mehta M, Khaitan BK, Sharma VK, Ramam M. The psychosocial impact of vitiligo in Indian patients. Indian J Dermatol Venereol Leprol. 2013;79:679-85.

Lerner AB. Vitiligo. J Dermatol. 1959;32:285-310.

Handa S, Dogra S: Epidemiology of childhood vitiligo: a study of 625 patients from North India. Ped Dermatol. 2003;20:207-10.

Yildirim M, Baysal V, Inaloz HS, Can M. The role of oxidants and antioxidants in generalized vitiligo at the tissue level. J Eur Acad Dermatol Venereol. 2004;18(6):683- 6.

Little C, O’Brien PJ. An intracellular GSH-peroxidase with a lipid peroxide substrate. Biochem Biophys Res Community. 1968;31:145 -7.

Lü JM, Lin PH, Yao Q, Chen C. Chemical and molecular mechanisms of antioxidants: Experimental approaches and model systems. J Cell Mol Med. 2010;14(4):840–60.

Hussein MA, Asada K. Monodehydroascorbate reductase from cucumber is a flavin adenine dinucleotide enzyme. J Biol Chem. 1985;260:920–6.

Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem. 2004;37(4):277-85.

Erel O.A. New automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38(12):1103-11.

Wang D, Feng JF, Zeng P, Yang YH, Luo J, Yang YM. Total oxidant/antioxidant status in sera of patients with thyroid cancers. Endoc Relat Cancer. 2011;18(6):773-82.

Njoo MD, Das PK, Bos JD, Westerhof W. Association of the koebner phenomenon with disease activity and the therapeutic responsiveness in Vitiligo vulgaris. Arch Dermatol. 1999;135(4):407-13.

Taieb A, Bordeaux CHU. Vitiligo. Pigment Cell Res. 2007; 20(5):418.

Alghamdi KM, Kumar A, Taieb A, Ezzedine K. Assessment methods for the evaluation of vitiligo. J Eur Acad dermatol Venereol. 2012;26(12):1463-71.

Turk Biyokimya Dergisi, Turkish Journal of Biochemistry–Turk J Biochem. 2012;37(1):29-34.

Bouayed J, Bohn T. Exogenous Antioxidants—Double-Edged Swords in Cellular Redox State: Health Beneficial Effects at Physiologic Doses versus Deleterious Effects at High Doses. Oxid Med Cell Longev. 2010;3(4):228-37.

Ines D, Sonia B, Riadh BM, Amel el G, Slaheddine M, Hamida T, et al. A comparative study of oxidant-antioxidant status in stable and active vitiligo patients. Arch Dermatol Res. 2006;298(4):147-52.

Maresca V, Roccella M, Roccella F, Camera E, Del Porto G, Passi S, et al. Increased sensitivity to peroxidative agents as a possible pathogenic factor of melanocyte damage in vitiligo. J Invest Dermatol. 1997;109:310-3.

Sravani PV, Babu NK, Gopal KVT, Rao GRR, Rao AR, Moorthy B, et al. Determination of oxidative stress in vitiligo by measuring superoxide dismutase and catalase levels in vitiliginous and non-vitiliginous skin. Indian J Dermatol Venereol Leprol. 2009;75:268-71.

Jain A, Mal J, Mehndiratta V, Chander R, Patra SK. Study of oxidative stress in vitiligo. Indian J Clin Biochem. 2011;26(1):78–81.

Siverberg NB. Update on childhood vitiligo. Curr Opin Pediatr. 2010;22(4): 445-52.

Jayanth DP, Pai BS, Shenoi SD, Balachandran C. Efficacy of antioxidants as an adjunct to photochemotherapy in vitiligo: A case study of 30 patients. Indian J Dermatol Venereol Leprol. 2002;68:202-5.


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