A comparative study of combined microneedling and narrowband ultraviolet B phototherapy versus their combination with topical latanoprost in the treatment of vitiligo

Abstract

Regardless of the continuous discovery of innovative modalities for the treatment of vitiligo, none of them ensure excellent therapeutic outcome. Microneedling had been suggested either singly or concomitantly with other therapeutic modalities for vitiligo with encouraging results. Latanoprost, a prostaglandin F2-alpha (PGF2α), and their analogues are recently recommended for vitiligo treatment. This study was designed to assess the therapeutic efficacy of microneedling in combination with NB-UVB phototherapy versus their combination with latanoprost in vitiligo. It was conducted on 50 patients presented with stable bilateral localized nonsegmental vitiligo. In every patient; two bilateral, nearly symmetrical lesions were selected and treated by microneedling (12 sessions at 2-week interval) followed by topical application of latanoprost 0.005% solution on one side, and topical saline (as placebo) on the other side. In addition, all patients received concomitant NB-UVB phototherapy (three sessions/week) for 6 months. Significant clinical improvement of vitiligo lesions with significant increase in the degree of repigmentation were reported in response to both treatment regimens. Latanoprost in combination with microneedling and NB-UVB provides more significant therapeutic outcomes than combined microneedling and NB-UVB. In conclusion, topical latanoprost 0.005% enhances the therapeutic efficacy of combined microneedling and NB-UVB phototherapy in localized stable nonsegmental vitiligo.

Clinical Effect of Microneedle Injection Combined with Blood Transfusion in the Treatment of Severe Anemia Complicated with Vitiligo under Regenerative Medical Technology

“…Microneedles were used to stimulate the skin, and numerous tiny tunnels were produced on the skin to allow the active substances to penetrate. The rolling of the microneedle could stimulate the dermis of the skin, causing collagen and fibroblasts to proliferate [21,22]. The patient's healthy skin (abdomen and buttocks) was firstly punctured with hollow microneedles.…”

Narrowband ultraviolet B phototherapy combined with intralesional injection of either latanoprost or platelet‐rich plasma for stable nonsegmental vitiligo

“…However, side effects of both modalities were generally tolerable and transient, which was consistent with earlier studies. [4][5][6][7][8][9][10][11][12]16,18 In the current study, the recurrence of depigmentation of treated lesions was significantly higher in latanoprost/NB-UVB group (22.2%) compared to PRP/NB-UVB group (no recurrence).…”

“…Similarly, Neinaa et al 8 demonstrated that the combination of topical latanoprost, microneedling, and NB-UVB resulted in a significantly higher repigmentation response than microneedling/ NB-UVB combination. Meanwhile, Stanimirovic et al 9 reported that topical latanoprost solution/NB-UVB combination could be beneficial for resistant vitiligo lesions, including acrofacial lesions; however, adding microneedling did not further improve the response.…”

A triple combination of latanoprost, fractional CO2 laser, and platelet‐rich plasma in localized vitiligo: A clinical and histopathologic study

“…4 Previous studies reported its effectiveness as a monotherapy in skin repigmentation applied either directly or with microneedling as a way of enhancing its delivery through the skin. [5][6][7][8] Latanoprost-induced repigmentation is believed to be mediated through modulation of melanocyte dendricity, melanosome transfer, melanocyte proliferation, and tyrosinase expression. 9 Fractional CO 2 (FCO 2 ) laser has been proposed as an effective add-on treatment for vitiligo.…”