Narrow‐band ultraviolet B as monotherapy and in combination with topical calcipotriol in the treatment of vitiligo

Abstract

Vitiligo is a common, idiopathic, acquired, depigmenting disease characterized by loss of normal melanin pigments in the skin. The most interesting treatment methods for extensive vitiligo involve psoralen plus ultraviolet A (PUVA) therapy and ultraviolet (UV)-B phototherapy, particularly narrow-band UV-B. In this randomized and comparative study, we investigated the safety and efficacy of narrow band ultraviolet B as monotherapy and in combination with topical calcipotriol in the treatment of generalized vitiligo. Of the 40 vitiligo patients enrolled in the study, 15 were treated with the calcipotriol plus narrow-band UV-B (NBUVB) and 25 with narrow band UV-B alone. The patients were randomized into two NBUVB treatment groups. The first group, consisting of 24 patients (all male), received only NBUVB treatment; the second group, consisting of 13 patients (all male) applied 0.05% topical calcipotriol ointments twice daily. Both groups were irradiated with NBUVB (311 nm). In the NBUVB group, the percentage of the body surface affected was reduced from 27.21 +/- 10.41% to 16.25 +/- 8.54% after a mean of 30 treatment sessions. The mean repigmentation percentage was 41.6 +/- 19.4%. In clinical evaluation (moderate and marked/complete response was accepted as an effective treatment), 19 patients (19/24; 79.17%) had clinically good results. In the NBUVB plus calcipotriol group, the percentage of the body surface affected was reduced from 23.35 +/- 6.5% to 13.23 +/- 7.05% after a mean of 30 treatment sessions. The mean repigmentation percentage was 45.01 +/- 19.15%. In clinical evaluation (moderate and marked/complete response was accepted as an effective treatment), 10 patients (10/13; 76.92%) had clinically good results. Statistically significant intragroup reductions from the baseline percentage of the body surface affected were seen at the endpoint of treatment for the two treatment groups (P < 0.001). However, there was no statistically significant difference between the two treatment groups at the end of therapy with respect to the reduction of repigmentation rates (P > 0.05). The present study reconfirmed the efficacy of NBUVB phototherapy in vitiligo. It can be a therapeutic option considered in the management of patients with vitiligo. However, addition of topical calcipotriol to NBUVB did not show any advantage.

Evaluation of Serum Vitamin D Levels in Patients with Vitiligo Undergoing NBUVB (Narrowband UV-B) Therapy

“…In our study, the average area of secondary involvement (VASI Score) in patients was lower than the initial average area of involvement, indicating the effectiveness of NBUVB therapy in the treatment of vitiligo, which is consistent with previous studies (2,15).…”

A Retrospective Study of Methylprednisolone Mini-Pulse Therapy Combined with Narrow-Band UVB in Non-Segmental Vitiligo

“…Studies reporting the use of NBUVB monotherapy in vitiligo reported initial repigmentation after 7-16 weeks of treatment in one study [14] and after an average of 34 treatments or 17 weeks of therapy in the other [15]. In studies using NBUVB for the therapy of vitiligo, overall repigmentation rates of 41.6-100% were reported to occur [15,16,17,18,19,20], and only 9% showed more than 75% repigmentation [17]. Although our study is retrospective and did not directly assess the effect of oral MPD mini-pulse therapy in association with NBUVB versus oral MPD mini-pulse therapy alone, the results observed in our series of patients treated with oral MPD mini-pulse therapy in association with NBUVB suggest that the combination of NBUVB and oral MPD mini-pulse therapy may induce repigmentation faster, and in a higher percentage of cases.…”

Analysis of Vitamin D Receptor Gene Polymorphisms in Vitiligo

“…There are a number of studies reporting conflicting results on repigmentation [4,5,6,7]. Vitamin D is known to influence melanocyte maturation, differentiation and melanogenesis.…”