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Version 3
A novel narrow band ultraviolet B (NB-UVB) perilesional irradiation for treating vitiligo with complete leukotrichia: A 12-week, open-label, double-arm, multicenter, randomized clinical trial
Description
Background: Vitiligo is a prevalent dermatological condition wherein the loss of melanocytes leads to skin depigmentation with or without leukotrichia. Existing phototherapies can be ineffective for treating vitiligo patients with complete leukotrichia. Our modified approach of ‘NB-UVB Perilesional Irradiation’ offers a new clinical alternative for treating vitiligo patients with complete leukotrichia.
Objective: This study aimed to compare the efficacy of NB-UVB Perilesional irradiation with conventional NB-UVB therapy for repigmentation in vitiligo patients with complete leukotrichia.
Methods: This is a 12-week, open-label, double-arm, multicenter clinical trial, with a total of 121 vitiligo patients included in the study protocol. All patients were required to have a patch of 100% white vellus hair on their body, with an area less than 1% of their body surface area. The subjects were randomly divided into two groups: one group received conventional NB-UVB irradiation (CI), while the other group received perilesional NB-UVB irradiation (PI). Both groups of patients received topical tacrolimus. The primary outcome was the mean percentage reduction in vitiligo area from baseline to week 12.
Findings: A statistically significant difference in improvement from baseline was observed in the PI group compared to the CI group (-30·8%±11·8%, -25·5%±11·05%, p=0·01) (pair-wise comparison p=0·900 at week 4, p=0·104 at week 8, p=0·01 at week 12). After subgroup analysis, patients older than 18 years old (p=0·014), with lesions on their limbs and trunk (p=0·003), or with a disease duration less than four years (p=0·029), obtained a superior efficacy of repigmentation with PI compared to CI. Meanwhile, at week 12, the average percentage change from baseline of leukotrichia in the irradiation area significantly decreased from 100% to 82·2±13·65% in the PI group, and from 100% to 88·7±9·64% in the CI group (p=0·027). Additionally, the lesions exhibited enhanced marginal repigmentation in the PI group (45/62 [72·58%]) compared to the CI group (p=0·008). Adverse events were minor, including desquamation and dryness, erythema, and blisters. No severe or lasting side effects were observed during the study.
Interpretation: PI has a better effect on the repigmentation of vitiligo with complete leukotrichia than CI and offers a valuable new therapeutic option for vitiligo patients with complete leukotrichia.
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Institutions
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Categories
Dermatology
Funding
National Natural Science Foundation of China
8227120662
National Natural Science Foundation of China
81872541
Licence
Creative Commons Attribution 4.0 International
Version 4
A novel narrow band ultraviolet B (NB-UVB)
Description
Background:
Institutions
Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital
Categories
Dermatology
Licence
Creative Commons Attribution 4.0 International