The role of systemic steroids and phototherapy in the treatment of stable vitiligo: a randomized controlled trial

Abstract

Pathogenesis of vitiligo is believed to be multifactorial disease with a wide variety of therapeutic modalities. The aim of this work is to assess the efficacy of oral mini-pulse steroids (OMP) plus Nb-U.V.B in comparison to OMP alone and Nb-U.V.B alone in treating stable vitiligo. A prospective randomized controlled study including 45 patients categorized into three groups receiving therapy for 3 months; Group A received Nb-U.V.B plus OMP, Group B received OMP alone while Group C received Nb-U.V.B alone. Clinical assessment and PCR evaluation of bFGF, ICAM1, and ELISA for AMA were done. Patients receiving Nb-U.V.B plus OMP and using Nb-U.V.B alone gave statistically significant clinical response than those treated with OMP alone. Statistically significant rise of BFGF was noticed after treatment with Nb-U.V.B plus OMP and with Nb-U.V.B alone. Patients treated with OMP alone and with Nb-U.V.B alone showed statistically significant drop of ICAM-1 after therapy. NB-U.V.B plus OMP and Nb-U.V.B alone were found to be clinically superior over OMP alone in treating stable vitiligo patients, hence suggesting that adding OMP to Nb-U.V.B can maintain clinical and laboratory success for a longer period of time and with less relapse.

Combination of carboxytherapy with narrowband‐ultraviolet B in the treatment of recalcitrant areas of vitiligo: A randomized clinical trial

“…In the current study, type of repigmentation in most of the cases in both treatment groups was both follicular and diffuse types that were similar to the ones by treatment modalities including immunomodulators and phothotherapy 13,14 . Most of the treatment modalities for vitiligo have poor efficacy on acral areas and lesions on bony prominence due to absence or low numbers of hair follicles 17,18 . However, in this study adding carboxytherapy to NB‐UVB leads to higher response rate in acral areas compared to previous studies.…”

Becker’s Nevus in a 24-Year-Old Female Patient with Rheumatoid Arthritis: A Case Report of a Laser Therapy Without Recurrence

“…Various reports have described the effects of these drugs on skin pigmentation. A study in 2016 reported that although topical corticosteroids might result in hypopigmentation due to potential melanocyte dysfunction, topical or oral use of corticosteroids, such as prednisolone, was effective in improving the pigmentation of patients with vitiligo (5). Another study revealed the development of hyperpigmentation in the skin of some patients taking methotrexate (6).…”

Clinical and Molecular Aspects of Vitiligo Treatments

“…NB-UVB has been shown to cause apoptosis of T-cells in active disease. By inducing IL-10, it stimulates the differentiation of Tregs, which also inhibit the autoreactive cytotoxic T-cells [ 84 , 85 , 86 , 87 ]. The biostimulation of functional melanocytes in the perilesional skin and immature melanocytes in hair follicles results in repigmentation after treatment with NB-UVB.…”