Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311-313 nm) in the treatment of vitiligo--a multicentre controlled study.

BACKGROUND: Vitiligo is an acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of epidermal melanocytes. Recently, it has been shown that narrowband ultraviolet B (NB-UVB) phototherapy may be more effective than psoralen and ultraviolet A (PUVA) photochemotherapy in treating vitiligo, and that 308-nm monochromatic excimer light (MEL) may present some advantages as compared to NB-UVB for the treatment of vitiligo. AIM The aim of this study was to compare the effectiveness of NB-UVB phototherapy and 308-nm MEL in vitiligo patients. METHODS: The study was done in a randomized, investigator-blinded and half-side comparison design. Twenty-one subjects with symmetrical vitiligo lesions were enrolled in this study. Vitiligo lesions on one body side were treated twice weekly for 6 months with 308-nm MEL, while NB-UVB phototherapy was used to treat lesions on the opposite side. RESULTS: At the end of the study six lesions (37.5%) treated with 308-nm MEL and only one lesion (6%) treated with NB-UVB achieved an excellent repigmentation (score 4) while four lesions (25%) treated with 308-nm MEL and five lesions (31%) treated with NB-UVB showed a good repigmentation (score 3). CONCLUSIONS: It appears that 308-nm MEL is more effective than NB-UVB in treating vitiligo lesions and it induces repigmentation more rapidly.

Tacalcitol and narrow-band phototherapy in patients with vitiligo.

BACKGROUND: Vitiligo is a skin disease characterized by loss of normal pigmentation in the skin. Several treatments exist but none is really effective. Recently, perturbations of calcium homeostasis in vitiliginous epidermis have been described. AIM: Based on these findings, the aim of this prospective, randomized, open-label study was to compare the effectiveness of narrow-band ultraviolet B (NB-UVB) phototherapy alone and the combination of NB-UVB and topical application of the vitamin D(3) analogue tacalcitol in the treatment of vitiligo. METHODS: In total, 32 subjects with generalized vitiligo and symmetrical lesions were enrolled in the study. Subjects were instructed to apply tacalcitol ointment daily to the lesion on the side randomly selected to receive combination therapy. All subjects received NB-UVB phototherapy on a twice-weekly schedule. RESULTS: Addition of topical tacalcitol to NB-UVB treatment improved the extent of repigmentation and increased the response rate in patients with vitiligo compared with NB-UVB treatment alone. CONCLUSION: Application of tacalcitol ointment in combination with twice-weekly NB-UVB phototherapy is an effective alternative treatment for patients with generalized vitiligo.

Monochromatic excimer light 308 nm in the treatment of vitiligo: a pilot study.

OBJECTIVE: To study the efficacy and safety of monochromatic excimer light (MEL) on 37 vitiligo patients referred to our clinic. METHODS: In a pilot study, 37 patients (17 males, 20 females) with acrofacial (n=21), focal (n=11), segmental (n=1), and generalized (n=4) vitiligo were treated twice weekly with MEL for a maximum period of 6 months. RESULTS: Thirty-five patients (95%) showed signs of repigmentation within the first eight treatments. The treatment resulted in good repigmentation in 16 patients, and excellent repigmentation in 18 patients. Adverse events were limited to transient erythema. In addition, some patients (n=3) not responding to prior narrow-band UVB (NB UVB) phototherapy showed good results with MEL in our series. CONCLUSIONS: Treatment with 308 nm MEL for vitiligo may be more effective in obtaining rapid repigmentation than phototherapy with NB UVB. The results in this study are similar to those recently reported with a 308 nm excimer laser, but 308 MEL could present some advantages: the possibility of treating larger areas compared to the 308 nm excimer laser, with shorter treatment times and better patient compliance. The overall good results and the early appearance of repigmentation contribute to reducing the cumulative exposure to UV radiation.