Swapnil Shah1,2,3,4, Jagadish Sakhiya1,2,3,4, Pranoti Deshpande1,2,3,4, Dhruv Sakhiya1,2,3,4, Arun C Inamadar1,2,3,4. 1. Dr. Shah is with the Ashwini Rural Medical College Hospital and Research Center Solapur in Maharashtra, India. 2. Drs J. Sakhiya and D. Sakhiya are with Sakhiya Skin Clinic in Surat, India. 3. Dr. Deshpande is with VM Medical College in Solpaur, India. 4. Dr. Inamdar is with MB Patil Medical College, in Vijaypura, Karnataka, India.
Abstract
Background: Vitiligo is an acquired disorder characterized by depigmented macules or patches on the skin due to the loss of functional melanocytes. Segmental vitiligo (SV) is a subtype of vitiligo refractory to treatment. Objective: We studied safety and efficacy of 308-nm monochromatic excimer light (MEL) in combination with 0.1% tacrolimus ointment for the treatment of SV. Methods: Fifty patients with SV were enrolled. MEL was given on alternate dates in combination with topical tacrolimus. Clinical photographs were taken once a month. Two independent dermatologists analyzed and graded the results. Results: Five patients were lost to follow-up. Concerning overall treatment success, 77.8 percent of patients demonstrated at least 75-percent repigmentation. More specifically, 35.6 percent of patients showed complete (100%) repigmentation (Grade 5), whereas 42.2 percent of patients showed more than 75-percent repigmentation (Grade 4). Conclusion: Combination therapy with topical 0.1% tacrolimus and a 308-nm excimer lamp appears to be efficacious with a good safety profile. The duration of disease was a statistically significant factor inversely correlated with treatment success rate. The site of vitiligo also plays a significant part in the outcome, as facial lesions responded best to the treatment.
Background: Vitiligo is an acquired disorder characterized by depigmented macules or patches on the skin due to the loss of functional melanocytes. Segmental vitiligo (SV) is a subtype of vitiligo refractory to treatment. Objective: We studied safety and efficacy of 308-nm monochromatic excimer light (MEL) in combination with 0.1% tacrolimus ointment for the treatment of SV. Methods: Fifty patients with SV were enrolled. MEL was given on alternate dates in combination with topical tacrolimus. Clinical photographs were taken once a month. Two independent dermatologists analyzed and graded the results. Results: Five patients were lost to follow-up. Concerning overall treatment success, 77.8 percent of patients demonstrated at least 75-percent repigmentation. More specifically, 35.6 percent of patients showed complete (100%) repigmentation (Grade 5), whereas 42.2 percent of patients showed more than 75-percent repigmentation (Grade 4). Conclusion: Combination therapy with topical 0.1% tacrolimus and a 308-nm excimer lamp appears to be efficacious with a good safety profile. The duration of disease was a statistically significant factor inversely correlated with treatment success rate. The site of vitiligo also plays a significant part in the outcome, as facial lesions responded best to the treatment.
Authors: Hani M J Khojah; Assaf G Alharbi; Abdulrahman A Alshaeri; Yaser M Alahmadi; Hossein M Elbadawy Journal: J Taibah Univ Med Sci Date: 2021-06-12