Minia University, Egypt
Title: PUVA & NB-UVB in management of vitiligo: Clinico-immuno-pathological comparative study
Background: Phototherapies are the most commonly used modalities in the treatment of vitiligo. Oral PUVA is the classical treatment and the NB-UVB is recently introduced without shorter erythemogenic wavelengths. Aims: This study designed to compare the effects of PUVA and NB-UVB clinically and immuno-pathogically in managing non segmental vitiligo. Patients/Methods: Thirty vitiligo patients, divided randomly into two groups treated either by oral PUVA or by narrow band UVB. After 4 months evaluation was done clinically and immuno-pathologically Results: One patient (3.3%) failed to respond to therapy in PUVA group of patients while 29 patients (93.3%) improved. Excellent repigmentation was achieved in 6.7% in PUVA group and 66.6% in NB-UVB group; good repigmentation was achieved in 60% in PUVA and 20% in NB-UVB while 26.7% in PUVA and 13.3% in NB-UVB showed mild repigmentation. The colour matching was excellent in NB-UVB patients. Recurrence and activation of vitiligo were in low percentage in PUVA treated cases. Microscopic examination revealed that dermal lympho-histiocytic infiltrate and the interface changes were more in biopsies from vitiliginous lesions treated with NB-UVB than with PUVA. Conclusions: The present study demonstrated that NB-UVB provides statistically significant better results than oral PUVA in managing non segmental vitiligo. Although NB-UVB therapy gives a rapid effect, yet the observation of decreasing recurrence and development of new lesions of vitiligo were significant with PUVA. It was also observed that PUVA has better immuno-modulatory effect on vitiligo than NB-UVB and will give better response on a longer period of time.