ABSTRACT
Background: Targeted ultraviolet B (T-UVB) phototherapy in vitiligo is usually administered twice or thrice a week on non-consecutive days. It is diffi cult for many patients to adhere to this regimen, forcing them to discontinue treatment. Aim: The study aimed to compare the effi cacy of twice-weekly and once-weekly targeted ultraviolet B phototherapy regimens in vitiligo. Methods: Sixty patients with non-segmental vitiligo on the face, neck or trunk were divided into two groups of 30 patients each. The patients in group A received targeted ultraviolet B twice weekly, while those in group B received targeted ultraviolet B once weekly. Repigmentation was monitored and graded as excellent (≥75% repigmentation), good (50−74% repigmentation) and poor (<50% repigmentation). The extent of repigmentation at each body site (primary outcome measure), the number of doses required for initiation of pigmentation, and the cumulative dose of targeted ultraviolet B administered was calculated and compared between both groups. Results: A total of 90 lesions (48 in the twice weeklygroup and 42 in the once weekly group) were treated on the face, neck and trunk. Excellent results were obtained in 62.5% (30/48) of lesions treated twice weekly, and 64.3% (27/42) in lesions treated once weekly. The mean number of doses required for initiation of pigmentation was 4.69 in the twice weekly group, and 4.35 in the once weekly group. The patients in the twice weekly group received a mean cumulative dose of 8.26 J/cm2, while the once weekly group received 7.69 J/cm2. No statistically signifi cant differences were observed between the two groups with respect to the outcome, with respect to the total repigmentation, the number of doses till onset of pigmentation, as well as the cumulative dose of targeted UVB. Conclusion: Once-weekly targeted ultraviolet B phototherapy appears to be as effi cacious as the twice-weekly regimen in vitiligo.
ABSTRACT
Background: Different surgical techniques in the form of tissue or cellular grafting procedures are used alone or in combination with narrowband UVB (NBUVB) to treat stable vitiligo resistant to medical treatment. Aim: To evaluate the cosmetic results obtained with ultrathin split-thickness skin grafts followed by NBUVB therapy in resistant, stable vitiligo. Methods: Forty patients of stable vitiligo were treated with ultrathin split-thickness grafting and the patients were then put on NBUVB therapy. The results obtained were analyzed by the extent of repigmentation achieved as well as the final cosmetic outcome at the recipient as well as donor sites. Results: The first evidence of repigmentation was seen in the second week after starting NBUVB. On objective assessment, more than 90% repigmentation was seen in 83% of patients and the overall cosmetic results at the recipient site were graded as good to excellent in 90% patients at the end of NBUVB treatment. Perigraft halo of depigmentation was seen in six patients (15%) on the recipient site. Hypertrophic scarring was observed in two patients at the donor site. Conclusions: Ultrathin split-thickness skin grafting, when combined with NBUVB therapy, leads to better cosmetic outcome with faster onset of repigmentation in resistant stable vitiligo.