A STUDY TO COMPARE THE EFFICACY OF NARROWBAND-UVB ALONE VERSUS NARROWBAND-UVB WITH TOPICAL TACROLIMUS 0.1% IN TREATMENT OF VITILIGO

Background: Vitiligo is a chronic skin condition characterized by the loss of pigment-producing cells, resulting in white patches on the skin. It affects 0.1-2% of people worldwide, regardless of gender or race, and can be particularly distressing for those with darker skin tones. While various treatment options have been studied, there is limited research comparing the effectiveness of narrow-band ultraviolet B (NB-UVB) therapy alone versus its combination with tacrolimus. This study aims to address this gap. Aim: The aim of this study is to compare the efficacy of Narrowband-UVB therapy alone versus Narrowband-UVB therapy combined with topical tacrolimus 0.1% in treating vitiligo. Methods: This was a randomized, open-label, prospective, comparative study, conducted over 18 months at the dermatology outpatient department of Basaweshwara Teaching and General Hospital, affiliated toMahadevappaRampure Medical College, Kalaburagi. 100 patients were enrolled, and demographic data were recorded during the initial visit. A comprehensive clinical and dermatological assessment was performed, including evaluation of the percentage of body surface area affected by vitiligo. 50 patients in Group 1 received Narrowband-UVB thrice weekly, while 50 patients in Group 2 received once-daily topical tacrolimus 0.1% in addition to Narrowband-UVB thrice weekly. The primary efficacy measure, Vitiligo Area Scoring Index (VASI), was assessed at baseline and every 2 months during the one-year follow-up period. Secondary efficacy was evaluated using Physician Global Assessment scores at the end of one year. Results: The study found that combination therapy with Narrowband-UVB and tacrolimus 0.1% resulted in earlier and more substantial treatment responses compared to Narrowband-UVB alone after 12 months. There was a statistically significant reduction in vitiligo area as measured by VASI (P=0.001) with combination therapy, particularly noticeable on the face and trunk. Physician Global Assessment scores indicated minimal improvement in VASI reduction for 40% of patients in the Narrowband-UVB group compared to 16% in the combination therapy group. Definite improvement was observed in 48% versus 52% of patients, and marked improvement in 8% versus 24%, respectively. Excellent improvement was noted in 4% of patients in the Narrowband-UVB group compared to 8% in the combination therapy group. Conclusion: Combination therapy using Narrowband-UVB with tacrolimus 0.1% appears to be more effective than Narrowband-UVB alone for treating vitiligo. It resulted in earlier and more significant repigmentation, particularly on the face and trunk, with minimal side effects observed for both treatments. These findings suggest that combining Narrowband-UVB with tacrolimus could offer an enhanced therapeutic option for patients with vitiligo.