Egypt: Vitiligo is a condition where the skin loses pigment. Vitiligo occurs in about 1% or slightly more of the population throughout the world. Treatment of vitiligo with intralesional steroid (ILS) injections has shown to be successful in quite a few studies.
A new study by Dr. Moetaz El-Domyati MD and team revealed that intralesional corticosteroid injections combined with NB-UVB are an efficient therapeutic option for vitiligo. Triamcinolone acetonide was the safest with fewer side effects and complications at 0.625 and 1.25 mg/ml. However, higher concentrations of 2.5 and 5 mg/ml were more effective but with more side effects. The findings of the study are published in The International Journal of Dermatology.
The objective of the study was to explore the efficacy and safety of using different concentrations of intralesional corticosteroid combined with NB-UVB phototherapy in the treatment of non-segmental vitiligo (NSV) patients.
The study included 22 patients with non-segmental vitiligo, they were subjected to different concentrations of ILS injections (triamcinolone acetonide); which was carried out monthly for six sessions. All patients were also subjected to twice-weekly sessions of NB-UVB for 6 months. Punch biopsy was taken from each patch before and at the end of treatment sessions. Each biopsy was stained with hematoxylin and eosin (H&E), Orcein, and Masson's trichrome stains.
The results of the study were:
• There was a significant difference between all groups in their repigmentation response.
• After treatment, the epidermal thickness (histometry) was decreased (epidermal atrophy).
• Concentrations of 2.5 and 5 mg/ml of intralesional triamcinolone acetonide injection showed decreased and disorganized collagen fibers.
El-Domyati and the team concluded that "Intralesional corticosteroid injections combined with NB-UVB showed a good and well-tolerated therapeutic option for vitiligo. The concentrations of 0.625 and 1.25 mg/ml of triamcinolone acetonide was the safest with fewer side effects and complications. However, higher concentrations of 2.5 and 5 mg/ml were more effective but with more side effects."
Reference:
The study titled, "The use of intralesional corticosteroid combined with narrowband ultraviolet B in vitiligo treatment: clinical, histopathologic, and histometric evaluation," is published in the International Journal of Dermatology.
DOI: https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.15940