Background
NB‐UVB has long been the vitiligo management pillar with capability of achieving the main treatment outcomes; repigmentation and stabilization. Its stabilizing effect in dark skin has been debatable. However, randomized controlled trials regarding NB‐UVB ability to control disease activity are lacking.
Purpose
To assess stabilizing effect of NB‐UVB in comparison to systemic corticosteroids, the mainstay in vitiligo stabilization, in skin photo‐types (III‐V).
Methods
This is a multicenter, placebo‐controlled, randomized, prospective study. Eighty patients with active nonsegmental vitiligo (NSV) (Vitiligo disease activity (VIDA) ≥2) were randomized to either NB‐UVB and placebo (NB‐placebo) or NB‐UVB and dexamethasone oral mini‐pulse (OMP) therapy (NB‐OMP) for 6 months. Sixty four patients completed the study, 34 in the NB‐OMP group and 30 in the NB‐placebo group. Patients were evaluated fortnightly according to presence or absence of symptoms/signs of activity.
Results
In spite of earlier control of disease activity observed in the NB‐OMP group, it was comparable in both groups by the end of the study period. Disease activity prior to therapy, but not extent, was found to influence control of activity in both groups. Thus, NB‐UVB is a safe sole therapeutic tool in vitiligo management. Not only does it efficiently achieve repigmentation, but also it is a comparable stabilizing tool for systemic corticosteroids in spite of slightly delayed control.
Conclusion
NB‐UVB is the only well‐established vitiligo therapy that can be used solely whenever corticosteroids are contraindicated or immune‐suppression is unjustified. Nonetheless, its combination with corticosteroids expedites response and improves compliance.
Surgical treatment of vitiligo lesions over the fingers has poor outcome. In this intrapatient comparative study, 12 patients with stable non-segmental vitiligo (NSV) affecting the middle three fingers of one hand were included. Three variations were used in treatment of finger vitiligo lesions: minipuch grafting, melanocytes keratinocyte transplantation procedure (MKTP) preceded by cryoblebbing or full CO 2 laser resurfacing of the recipient site. Liquid nitrogen was used to create blebs in one
Our study suggests reducing PUVA frequency and the cumulative UVA dose does not compromise the efficacy of PUVA, but it may improve its benefit/risk ratio. RESTRICTIONS: Few number of cases.
BB-UVA appears to be safe and acceptable for the treatment of chronic plaque psoriasis possibly through bcl-2-mediated apoptosis of keratinocytes and epidermal lymphocytes.
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