EFFICACY OF NB-UVB IN PROGRESSIVE VERSUS NON-PROGRESSIVE NON-SEGMENTAL VITILIGO: A COMPARATIVE STUDY SUGGESTING IMMUNOMODULATORY ROLE OF NB-UVB IN VITILIGO.
- Binod K. Khaitan, India
Abstract
Background and Aims
The progression of vitligo has been the direct effect of auto-immunity mediated destruction of melanocytes. The effect of narrow-band UVB on disease progression in vitiligo has not been evaluated. We evaluated the effect of NB-UVB on progressive versus non-progressive non-segmental vitiligo.
Methods
Adult patients having non-segmental vitiligo >2% BSA were divided into two subsets; patients developing >5 lesions in last 1 month or >15 lesions in last 3 months [Progressive vitiligo, group I] and patients with static disease for last 6 months [Non-progressive vitiligo, group II]; Both groups were treated with NB-UVB for 6 months and its efficacy in halting disease progression, re-pigmentation, side-effects and psychosocial impact were evaluated.
Results
Twenty-four out of 31 patients with progressive vitiligo (group I); and 9 out of 17 with non-progressive vitiligo (group II) completed the study period of 6 months. At the end of 6 months, 19 out of 24 patients had arrest of disease progression while the rest five patients developed lesions at a slower pace. After 6 months, majority of patients; 19 out of 24 (79%) in group I and 6 out of 9 (67%) in group II, had 25-50% re-pigmentation. Pruritus (20/33 patients; 60.6%), blistering (7/33 patients; 21.2%), pain (4/33 patients; 12.1%) and burning sensation (4/33 patients; 12.1%) were the side-effects.
Conclusions
Besides achieving re-pigmentation, NB-UVB has potential to halt disease progression in some patients with progressive vitiligo, with minimal side-effects. Autoimmunity being the definitive factor in progression of vitiligo, these results suggest that NB-UVB may be having an immunomodulator effect in vitiligo.