COMPARISON OF EFFICACY OF TCI MONOTHERAPY WITH TCI AND NARROW BAND UVB IN VITILIGO: A HOSPITAL BASED STUDY.

Abstract

Background:
 A skin condition known as vitiligo is an advanced depigmentation of the skin that is characterized by the development of depigmented macules that cause significant social and psychological distress. Although there are various therapy options available, vitiligo management is still a therapeutic challenge for many dermatologists. Topical calcineurin inhibitors, ultraviolet B phototherapy, and topical steroids are examples of conservative treatments.
 Objective: This study aims to compare the effectiveness of tacrolimus monotherapy and narrowband ultraviolet B phototherapy (NB-UVB) for treating vitiligo.
 Materials and Methods: :For a period of two years, 100 vitiligo patients who presented to the dermatology outpatient department of the first Dali university associated hospital underwent a prospective and comparative study (from 2018-1-1 to 2019-12-31). All of the participants in this study met the inclusion and exclusion criteria after receiving the necessary ethical approval. According to the vitiligo data Proforma, demographic information was checked during the initial appointment.
 All individuals with vitiligo underwent a complete clinical and dermatological examination of their condition. The associated laboratory tests were all finished. It was assessed how much of the body's surface area is affected by vitiligo. On the basis of their course of therapy, patients were divided into two groups at random. Tacrolimus ointment was applied topically to 50 patients in group A twice daily. 50 patients in group B received topical medication three times per week in addition to NB-UVB phototherapy.
 The VASI (Vitiligo Area Severity Index) was used to compare the effectiveness of the two groups from the beginning of the trial to its conclusion. Global ratings from both patients and physicians were calculated as part of the study's secondary efficacy measure. Software called SPSS 23.0 was used to do the statistical analysis. At p 0.05, the difference was statistically significant.
 Results: After 12 months of treatment, topical treatment alone outperformed Narrow Band UVB in terms of overall effectiveness. Patients treated with narrow band UVB plus topical treatment have earlier repigmentation response to lesions in the face, trunk, upper limbs, and lower limbs than those treated with topical treatment alone. When comparing the trunk, face, upper, and lower limbs for both types of therapies, lesions in the hands and feet require a lengthier course of treatment.
 Conclusion: 
 Narrow band UVB along with TCI is of higher efficacy, better tolerated and superior to TCI monotherapy in the treatment of vitiligo. There was a statistically significant reduction in percentage of VASI p= with Narrow Band UVB along with TCI group when compared to TCI mono therapy alone.