Narrow-band UVB therapy and topical calcineurin inhibitors for the treatment of paediatric vitiligo in real clinical practice

Ilona Hartmane (Coresponding Author), Ingmārs Mikažāns, Iveta Ivdra, Irēna Mirzajanova, Andra Dērveniece, Vanda Bondare-Ansberga

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Abstract

Vitiligo is an acquired chronic skin disease, characterised by progressing, usually symmetric,
depigmented areas in human skin. Vitiligo affects 0.5% of the human population, however, optimal treatment combination real clinical practice has yet to be found. The aim of the study was to
assess whether combined therapy with ultraviolet B (UVB) therapy and calcineurin inhibitors
(CNI) provides superior response in vitiligo patients, compared with phototherapy or topical CNI
monotherapy. We performed a retrospective cohort study of children treated for vitiligo from January 2016 to December 2019. Primary outcome measures include clinical efficacy defined by area
of repigmentation — good clinical efficacy (re-pigmentation of 50% of lesion surface area), positive clinical efficacy and poor clinical efficacy (re-pigmentation of < 15% of lesion surface area).
Secondary outcome measures included reduction of lesion size and tolerability of therapy. A total
of 114 patients were recruited in the study, 46 allocated to the topical CNI therapy group, 36 to
the narrow band (Nb-UVB), and 32 to the combined therapy group. All treatments statistically significantly decreased lesion surface area compared to the baseline (mean, SD). Local therapy reduced lesions from 8.5 (5.7) to 5.3 (4.2) by 37.3% (p < 0.0001), phototherapy reduced lesions
from 9.8 (5.4) to 5.7 (3.92) by 42.3% (p < 0.0001), and combined therapy reduced lesions from
14.2 (4.8) to 6.58 (3.5) by 53.6% (p < 0.0001), with combined therapy showing superior numerical
efficacy. Clinical efficacy for CNI monotherapy was 67.4%, for phototherapy — 80.5%, and for
combined therapy 93.7%. The safety profile of therapies was consistent with other studies. Our
results support the use of combined therapy in vitiligo patients.
Original languageEnglish
Pages (from-to)200-205
Number of pages6
JournalProceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.
Volume75
Issue number3
DOIs
Publication statusPublished - 1 Jun 2021

Keywords*

  • depigmentation
  • phototherapy
  • treatment
  • skin

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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