Treatment of stable nonsegmental vitiligo using transdermal delivery of 5-fluorouracil by fractional CO2 laser versus intralesional injection of 5-fluorouracil, both followed by narrow-band type ultraviolet B (UVB): A comparative study.

BACKGROUND: Updates of treatment methods of stable vitiligo are needed to give better outcomes with a shorter duration of treatment. OBJECTIVE: To test the effect of transdermal 5-fluorouracil (5-FU) delivery using fractional CO2 (FrCO2 ) laser versus intralesional 5-FU injection, with narrow-band type ultraviolet B (UVB) (NB-UVB) therapy after both, in the treatment of stable vitiligo. PATIENTS AND METHODS: The present study comprised 40 patients with nearly symmetrical stable vitiligo lesions. The left side was treated with FrCO2  laser followed by topical 5-FU (FrCO2  + 5-FU), while the right side was treated with 5-FU intradermal injection. Both procedures were done at 2-week intervals for 3 sessions followed by 24 sessions of narrow-band UVB for both sides. RESULTS: Repigmentation was demonstrated on the left side of 90% of patients and the right side of 85% of patients. As much as >50% improvement was demonstrated on the left side of 50% of patients, and the right side of 55% of patients. Intralesional 5-FU showed a statistically significant difference in repigmentation compared to FrCO2  + 5-FU. CONCLUSION: Both 5-FU injection and FrCO2  + 5-FU were effective therapeutic modalities for vitiligo. Patients were more compliant with FrCO2  + 5-FU.