Response to Narrow-Band UVB — Vitiligo-Melasma Versus Vitiligo
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Background: Vitiligo is the most common depigmentary disorder of the skin and hair, resulting from selective destruction of melanocytes. Melasma, a hyperpigmentary disorder, presents as irregular, brown, macular hypermelanosis. A small subset of vitiligo patients paradoxically also have melasma.
Objective: To evaluate and compare the response to narrow-band UVB in a group of patients with vitiligo, and another group of patients with vitiligo and coexisting melasma (vitiligo-melasma).
Methods: Patients in both groups were treated with narrow-band UVB and a comparison of the zonal repigmentation was made at 4, 8, and 12 weeks after the initiation of therapy.
Results: At the end of 12 weeks, 86% of patients in the vitiligo-melasma group attained ≥75% pigmentation on the face, whereas this was achieved in only 12.5% of patients in the vitiligo group. Over the limbs, 73% of patients in the vitiligo-melasma group attained 75% or more pigmentation at the end of 12 weeks compared with only 9% in the vitiligo group. On the trunk, only 20% of vitiligo-melasma patients showed ≥75% pigmentation at 12 weeks compared with 63% of patients in the vitiligo group.
Conclusion: Patients having both vitiligo and melasma have a significantly better prognosis for repigmentation on the face and limbs with narrow-band UVB compared with patients with vitiligo alone; the vitiligo-melasma patients achieve repigmentation much earlier and also attain a greater level of repigmentation. Unexpectedly, for truncal lesions, patients with vitiligo alone responded better than those with both conditions. Although the vitiligo-melasma group with truncal lesions started repigmenting earlier, the final pigmentation was more extensive in the vitiligo group.
No sources of funding were used to conduct this study. The authors have no conflicts of interest that are directly relevant to the content of this study.
- 2.Moscher DB, Fitzpatrick TB, Ortonne JP, et al. Hypomelanosis and hypermelanosis. In: Eisen AZ, Wolff K, Austen KF, et al., editors. Dermatology in general medicine. 6th ed. New York: McGraw Hill, 2003: 836–80Google Scholar
- 3.Sarin RC, Kumar AS. A clinical study of vitiligo. Indian J Dermatol Venereol Leprol 1977; 43 (6): 311–4Google Scholar
- 4.Sharma SC. Autoimmune and cutaneous association in various types of vitiligo. Indian J Dermatol Venereol Leprol 1999; 57: 107–8Google Scholar
- 6.Puri N. Etiopathogenesis and growth factors. Asian Clin Dermatol 1994; 1: 17–20Google Scholar
- 8.Dutta AK. Studies on vitiligo with special reference to neural concept. Indian J Dermatol Venereol Leprol 1977; 43: 190–3Google Scholar