Comparative Clinical and Histological Study of Narrow Band UVB Phototherapy Versus Combined Narrow Band UVB Phototherapy and Microneedling in Treatment of Vitiligo

Abstract

Background: Vitiligo is an acquired pigmentary disorder of unknown etiology that affects up to 1% of the general population of all skin types. It is a multifactorial disorder. There are numerous medical and surgical treatments aimed at repigmentation. Microneedling is a minimally invasive procedure that uses fine needles to puncture the epidermis. The indications for microneedling therapy have grown significantly and it is becoming a widely used treatment in Dermatology. Aim of Study: To study the clinical and histological efficacy of combined NB-UVB phototherapy and microneedling versus NB-UVB phototherapy in the treatment of vitiligo. Patients and Methods: Twenty patients were divided into two Groups (A & B), each of 10 patients. Both groups were matched regarding age, sex, skin type and have a depigmented patch at the same corresponding site. Group A was subjected to microneedling with dermapen at one depigmented patch followed by NB-UVB phototherapy sessions twice weekly for three months. Group B was subjected to NB-UVB phototherapy sessions twice weekly for three months. Two Skin biopsies one before and one after the therapy were taken for immunohistochemical examination by HMB 45. Results: The mean percentage of improvement was significantly high in Group A (48.50% ± 26.46) than Group B (20.0% ± 19.58). In Group A 20% showed mild improvement (G1), 20% showed moderate improvement (G2), (40%) showed good improvement (G3) and 20% showed excellent improvement (G4). In Group B 30% showed no improvement, 50% showed mild improvement (G1), 10% showed moderate improvement (G2) and 10% showed good improvement (G3). There was statistically significant difference between both groups (p=0.027*). Immunohistochemical changes revealed marked expression of HMB45 in Group A more than Group B, the mean of color intensity in Group A was 0.05 ±0.04 and a median of 0.03

Applications of microneedling for various dermatologic indications with a special focus on pigmentary disorders: A comprehensive review study

“…[99][100][101][102][103][104][105][106][107] In a comprehensive systematized survey we summarized our literature review on the effect of microneedling in patients with three main pigmentary disorders including melasma, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] periorbital darkening [20][21][22] and vitiligo. 4,20,21,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]…”

“…Working on associations and promising therapeutic options of many mucocutaneous disorders is of great importance in the research fields of dermatology and needling could be one of the highly recommended procedures for various indications so that pigmentary disorders are not any exceptions and there are increasing rate of publications in the literature in this regard 99–107 . In a comprehensive systematized survey we summarized our literature review on the effect of microneedling in patients with three main pigmentary disorders including melasma, 4–19 periorbital darkening 20–22 and vitiligo 4,20,21,24–39 …”

Evaluation of efficacy and safety of vitiligo treatment with micro‐needling combined with N‐Acetylcysteine and micro‐needling alone: A double‐blinded randomized controlled clinical trial

“…Another study by Amira et al 30 . in 2019 compared the effects of microneedling combined with phototherapy.…”

“…Another study by Amira et al 30 in 2019 compared the effects of microneedling combined with phototherapy. They reported a significantly improved response in the group that received microneedling before phototherapy compared to phototherapy alone.…”