The effectiveness of narrow-band phototherapy, corticosteroid, and methotrexate on clinical picture and serum level of soluble interleukin-2 receptors among vitiligo patients

Abstract

Objective Vitiligo is a specific type of leukoderma characterized by depigmentation of the epidermis. This study aimed to compare the effectiveness of methotrexate, narrow-band phototherapy, and corticosteroid as three different treatment modalities for vitiligo. Patients and methods The study included 52 patients suffering from nonsegmental vitiligo and 20 healthy participants that served as the control group. They were recruited from the Dermatology Outpatient Clinic, National Research Center (Cairo, Egypt). The patients were randomly divided into three groups according to the treatment modalities (narrow-band ultraviolet radiation, methrotrexate, and corticosteroids). Clinical evaluation and serum level of soluble interleukin-2 receptor (sIL-2R) estimation were performed before and after treatment with follow-up duration of 6 months. Results The serum level of sIL-2R was significantly higher among patients compared with controls. The study also showed a highly statistically significant lowering of serum level of sIL-2R among both narrow-band-treated and corticosteroid-treated patients, whereas the decrease was not statistically significant among those treated with methotrexate. No statistically significant difference was detected between the three groups of patients regarding clinical response to treatment or severity of the disease. However, regarding patient satisfaction it was significantly higher among both narrow-band-treated and corticosteroid-treated patients compared with those belonging to the methotrexate group. A statistically significant negative correlation between patient satisfaction and serum level of sIL-2R after treatment was detected. Conclusion No statistically significant difference was detected between the three modalities of treatment (narrow-band ultraviolet radiation, methrotrexate, and corticosteroids) regarding clinical response or severity of the disease. However, only narrow band and corticosteroid significantly decreased the serum level of sIL-2R. Patients receiving methotrexate reported the least satisfaction compared with the other two groups.