Comparative study of topical latanoprost, tacrolimus and clobetasol propionate in combination with microneedling and narrow-band ultraviolet B in the treatment of non-segmental vitiligo

Abstract

Vitiligo is a depigmentation disease of the skin with unknown etiology. Different treatment modalities were considered in treatment of vitiligo but without sufficient satisfactory outcome. In the current study we aimed to compare the efficacy and safety of topical latanoprost, tacrolimus, clobetasol propionate when combined with microneedling and NB-UVB in the treatment of nonsegmental vitiligo. We included 30 patients presented with vitiligo. Each patients had at least 5 patches of stable vitiligo and the patches were divided into 5 groups according to treatment used as follows; 1) Microneedling + latanoprost and NB-UVB 2) Microneedling + topical tacrolimus and NB-UVB 3) Topical clobetasol propionate and NB-UVB 4) NB-UVB 5) Control All patches were assessed before and after treatment using Digital photography, measurement of surface area of vitiligo patches using VESTA and VACAG scores. Patients’ satisfaction was performed after end of treatment protocol for every therapeutic modality. Assessment of patients’ response to treatment revealed that microneedling + latanoprost and NB-UVB had the best repigmentation outcome and highest satisfaction scores. It was followed by microneedling + tacrolimus and NB-UVB then topical clobetasol propionate and NB-UVB and finally NB-UVB monotherapy. Regarding safety of considered therapies, pain and erythema was reported with Microneedling + latanoprost and NB-UVB and Microneedling + topical tacrolimus and NB-UVB. Itching was associated with Microneedling + topical clobetasol propionate and NB-UVB while burning and dryness were associated with NB-UVB therapy.