Comparative Study between Ultraviolet-B Phototherapy Alone and Ultraviolet-B Phototherapy with Topical Tacrolimus in the Treatment of Vitiligo
DOI:
https://doi.org/10.51253/pafmj.v74i4.9390Keywords:
Phototherapy, Tacrolimus, Ultraviolet-B phototherapy, Vitiligo.Abstract
Objective: To compare the combined effect of Ultraviolet-B plus Tacrolimus Vs Ultraviolet-B alone in the treatment of Vitiligo.
Study Design: Randomized-controlled trial (ClinicalTrials.gov: NCT05577637).
Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Abbottabad Pakistan, May to Nov 2021.
Methodology: Sixty patients aged 20-60 years were enrolled. Patients in Group-A applied 0.03% topical Tacrolimus twice daily on body and 0.01% Tacrolimus twice daily on face with UVB phototherapy thrice weekly. In Group-B only UVB was given thrice weekly for depigmented patches at a dose of 0.021 j/cm2 after calculating minimal erythema dose and it was incremented by 10% at every visit. The treatment efficacy was determined as percentage of re-pigmentation monthly for three months. By following up categorizing re-pigmentation as excellent (>75%) to poor (<25%).
Results: In Group-A mean age 36.36+9.75 years, and in Group-B mean age were 32.50+9.02 years. The two groups were evaluated in terms of pre-treatment clinical parameters there was insignificant relations between them (p>0.05). The majority 19(63.4%) of Group-A patients and 23(76.7%) Group-B patients had 1-10% depigmentation level and rest of patients had greater than 11%. While comparing the efficacy Group-A 17(56.7%) patients responded effectively as compared to 08(26.7%) patients in Group-B (p-value <0.05).
Conclusions: When compared to UVB alone, the combined effect of UVB plus Tacrolimus 0.03% for body and 0.01% for face, was significantly greater than Tacrolimus alone.
Downloads
References
Passeron T. Combined/Sequential/Integrated Therapies for Vitiligo. In Vitiligo 2019. Springer, Cham.
Sureshkumar R. Vitiligo: A Review of its Aspects and Treatment Modalities. Asian J Pharm 2018; 12(1): 36-41.
Nicolaidou E, Antoniou C, Stratigos A, Katsambas AD. Narrowband ultraviolet B phototherapy and 308-nm excimer laser in the treatment of vitiligo: a review. J Am Acad Dermatol 2009; 60(3): 470-477. https://doi.org/10.1016/j.jaad.2008.07.053
Lotti T, Buggiani G, Troiano M, Assad GB, Delescluse J, De Giorgi V, et al. Targeted and combination treatments for vitiligo comparative evaluation of different current modalities in 458 subjects. Dermatol ther 2008;21: S20-26.
https://doi.org/10.1111/j.1529-8019.2008.00198.x
Khalili M, Amiri R, Mohammadi S, Iranmanesh B, Aflatoonian M. Efficacy and safety of traditional and surgical treatment modalities in segmental vitiligo: A review article. J Cosmet Dermatol 2022; 21(6): 2360-2373.
https://doi.org/10.1111/jocd.14899
Berti S, Buggiani G, Lotti T. Use of tacrolimus ointment in vitiligo alone or in combination therapy. Skin Therap Lett 2009; 14: 5-7.
Dong Y, Yang Q, Guo B, Zhu J, Sun X. The effects of tacrolimus plus phototherapy in the treatment of vitiligo: a meta-analysis. Arch Dermatol Res 2021; 313(6): 461-471.
https://doi.org/10.1007/s00403-020-02121-x
Esfandiarpour I, Ekhlasi A, Farajzadeh S, Shamsadini S. The efficacy of pimecrolimus 1% cream plus narrow-band ultraviolet B in the treatment of vitiligo: a double-blind, placebo-controlled clinical trial. J Dermatol Treat 2009; 20(1): 14-18.
https://doi.org/10.1080/09546630802155057
Goulden V, Ling TC, Babakinejad P, Dawe R, Eadie E, Fassihi H, et al. British Association of Dermatologists and British Photodermatology Group guidelines for narrowband ultraviolet B phototherapy 2022. Br J Dermatol 2022; 187(3): 295-308.
https://doi.org/10.1111/bjd.21669
Dayal S, Sahu P. UVB Therapy in Vitiligo. In Comprehensive Textbook on Vitiligo. CRC Press, 2020.
Majid I. Does topical tacrolimus ointment enhance the efficacy of narrowband ultraviolet B therapy in vitiligo? A left-right comparison study. Photodermatol Photoimmunol Photomed 2010; 26: 230-234.
https://doi.org/10.1111/j.1600-0781.2010.00540.x
Utami RD, Murti MT, Risman M, Kusumawardhani A. Double-blind randomized trials once a week narrowband ultraviolet B (NB-UVB) phototherapy in vitiligo. J Gen Proced Dermatol Venereol Indones 2018; 2(3): 4.
https://doi.org/10.19100/jdvi.v2i3.93
Rea H, Kirby B. A Review of Cutaneous Microdialysis of Inflammatory Dermatoses. Acta Derm Venereol 2019; 99(11): 3223.
https://doi.org/10.2340/00015555-3223
Sakhiya JJ, Sakhiya DJ, Gandhi SP, Gajjar TP, Banker SJ, Gandhi JM, et al. The Efficacy of 311-NM Narrowband Ultraviolet B (NB-UVB) and Topical Agents or Lasers Combination Therapy versus NB-UVB Monotherapy for Vitiligo: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Clin Diagn Res 2019; 13(7): 13-21.
https://doi.org/10.7860/JCDR/2019/41273.13021
Karagaiah P, Valle Y, Sigova J, Zerbinati N, Vojvodic P, Parsad D, et al. Emerging drugs for the treatment of vitiligo. Expert Opin Emerg Dr 2020; 25(1): 7-24.
https://doi.org/10.1080/14728214.2020.1712358
Ebrahim HM, Elkot R, Albalate W. Combined microneedling with tacrolimus vs tacrolimus monotherapy for vitiligo treatment. J Dermatol Treat 2021; 32(8): 999-1004.
https://doi.org/10.1080/09546634.2020.1716930
Bilal A, Shiakh ZI, Khan S, Iftikhar N, Anwar I, Sadiq S. Efficacy of 0.1% topical tacrolimus with narrow band ultraviolet B phototherapy versus narrow band ultraviolet B phototherapy in vitiligo. J Pak Assoc Dermatol 2014; 24(4): 327-331.
Farajzadeh S, Esfandiarpour I, Khandani EP. Efficacy of combination therapy of pimecrolimus 1% cream and mometasone cream with either agent alone in the treatment of childhood vitiligo. J Pak Assoc Dermatol 2019; 28(4): 507-513.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Rohida Rahmat, Majid Hussain, Bushra Muzaffar, Nadia Akbar, Adeel Siddiqui, Kanza aftab
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.