Treatment of non-segmental vitiligo in the resistant localizations with NB-UVB after application of erbium: YAG laser plus pimecrolimus in comparison with NB-UVB after application of Erbium: YAG laser plus topical steroid

Abstract

Background: Vitiligo is an acquired depigmentation condition. It affects around 0.1%-2% of the general population, regardless of ethnicity, gender, or socioeconomic status of the affected individuals. Vitiliginous patches contain either reduced melanin or no pigment at all.
Objective: This study aimed to evaluate the efficacy of Erbium: YAG (Er: YAG) laser plus pimecrolimus and narrowband ultraviolet B (NB-UVB) (on the right side) in comparison with Er: YAG laser plus topical steroid and NB-UVB (on the left side of the same patient) in treatment of vitiligo in the resistant localizations.
Patients and methods: The study comprised thirty patients with persistent non-segmental vitiligo and at least two symmetrical lesions on bony prominences and/or extremities. Patients were selected from the Outpatient Dermatological Clinic of Mataria Teaching Hospital.
Results: Regarding the area of the lesion on the right side, there was statistically significant difference between the area of the lesion before and after treatment at the 1st, 2nd, 3rd and 6th month of treatment. On the left side, there was also statistically significant difference between the area of the lesion before and after treatment at the 1st, 2nd, 3rd and 6th month of treatment. The higher percentage of improvement was seen in the knees followed by the elbows, while the lateral malleolus has 0% of improvement on both the right and left sides.
Conclusion: From this study we concluded that skin ablation by Er: YAG laser followed by NB-UVB in combination with either pimecrolimus or hydrocortisone is one of the alternative treatment modalities in treatment of stable, resistant vitiligo patches with almost no difference between the two treatment lines.