Efficacy of 308-nm Monochromatic Excimer Lamp and Topical Tacrolimus Combination Therapy in Localized Vitiligo: A Study in Vietnam

Abstract

Objective: Combination therapy of a 308-nm monochromatic excimer lamp and topical tacrolimus is widely used in the treatment of localized vitiligo; however, there are no published studies investigating this combination therapy in Vietnamese patients with vitiligo. This study was performed to evaluate the efficacy of combined excimer lamp and topical tacrolimus therapy for patients with localized vitiligo in Vietnam. Methods: We performed a pre-post clinical trial of 30 patients diagnosed with localized vitiligo in Vietnam. The patients were treated with an excimer lamp twice weekly and with topical tacrolimus twice daily. Effectiveness was evaluated based on the reduction rate of the vitiligo area scoring index (VASI). Data were analyzed using descriptive statistics, Fisher’s exact test, Kruskal-Wallis H test, and Spearman correlation coefficient test. Results: After 12 weeks of treatment, response was excellent or good in 16 patients (53.3%), moderate in 8 patients (26.7%), and poor in 6 patients (20.0%). The excellent or good responses increased over time from 3 patients (10.0%) at 6 weeks to 16 patients (53.3%) at 12 weeks (P = 0.001). Earlier initiation of repigmentation was associated with a better response to treatment (r = −0.71; P = 0.020). Patients with a perifollicular repigmentation pattern responded better to treatment than those with combined or marginal repigmentation patterns (P = 0.003). Side effects occurred in 13 patients (43.3%), including burning (43.3%), pruritus (10.0%), and mild blistering (6.7%), and none of these interrupted the treatment. Conclusion: Combination therapy with excimer lamp and topical tacrolimus appears to be effective and safe in treating patients with localized vitiligo in Vietnam.