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Title: Comparative Study between Ultraviolet-B Phototherapy Alone and Ultraviolet-B Phototherapy with Topical Tacrolimus in the Treatment of Vitiligo
Authors: Rohida Rahmat, Majid Hussain, Bushra Muzaffar, Nadia Akbar, Adeel Siddiqui, Kanza aftab
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2024
Volume: 74
Issue: 4
Language: English
Keywords: PhototherapyTacrolimusUltraviolet-B phototherapyVitiligo.
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.
To compare the combined effect of Ultraviolet-B plus Tacrolimus vs Ultraviolet-B alone in the treatment of Vitiligo.
Randomized-controlled trial conducted from May to November 2021. Sixty patients aged 20-60 years were enrolled. Group A received 0.03% topical Tacrolimus on the body and 0.01% on the face twice daily with UVB phototherapy thrice weekly. Group B received UVB phototherapy alone thrice weekly. Treatment efficacy was assessed monthly for three months based on the percentage of re-pigmentation.
graph TD
A[Patient Enrollment n=60] --> B[Randomization];
B --> C[Group A: UVB + Tacrolimus];
B --> D[Group B: UVB Alone];
C --> E[Treatment - 3 months];
D --> E;
E --> F[Repigmentation Assessment];
F --> G[Data Analysis];
G --> H[Conclusion];
The combined effect of Tacrolimus plus UVB is higher compared to UVB alone, which is similar to other studies. Demographic variables such as gender, duration, type of skin, type of vitiligo had also insignificant relationship with combination therapy which is similar to our study results.
Group A (UVB + Tacrolimus) showed significantly greater repigmentation compared to Group B (UVB alone) (p < 0.05). 56.7% of patients in Group A responded effectively compared to 26.7% in Group B.
The combined effect of UVB plus Tacrolimus was considerably higher compared to UVB alone in the treatment of vitiligo.
1. Sixty patients aged 20-60 years were enrolled: Confirmed in the Methodology and Results sections.
2. Group A received 0.03% topical Tacrolimus on the body and 0.01% on the face: Confirmed in the Methodology section.
3. 56.7% of patients in Group A responded effectively compared to 26.7% in Group B: Confirmed in the Key Findings and Results sections.
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