Evaluation of the efficacy of NB-UVB phototherapy and topical decapeptide versus NB-UVB phototherapy, topical decapeptide, and carbon dioxide laser in the treatment of stable vitiligo

Background: Vitiligo is an acquired disorder of autoimmune destruction of melanocytes. The management challenges include stabilizing the disease and devising methods for inducing repigmentation. Phototherapy and laser therapy offer promising results, along with topical treatments such as Basic Fibroblast Growth Factor (bFGF)-related topical decapeptide. Aims: This prospective interventional study aimed to assess and compare the efficacy of a triple combination therapy of fractional CO 2 laser, Narrow Band-Ultraviolet B (NB-UVB) phototherapy, and topical decapeptide with dual combination of NB-UVB phototherapy and topical decapeptide in the treatment of stable vitiligo. Methods: Patients with stable vitiligo were enrolled for 15 months and divided into two groups: one receiving dual combination therapy and the other the triple combination therapy. Lesions were evaluated using a quartile-grading scale at regular intervals over 16 weeks. Vitiligo noticeability scale (VNS) was used by an independent observer (who was not a part of the study) and by the patient/attendant to eliminate any observation bias. Statistical analysis was done using Pearson chi-square test. Results: Of the 32 enrolled patients, the triple combination therapy demonstrated superior repigmentation outcomes compared to dual therapy, with statistically significant differences observed at all assessment intervals. Side effects were mild and transient. Conclusion: The study highlights the efficacy of triple combination therapy in treating stable vitiligo, particularly for patients with refractory vitiligo. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings and optimize treatment protocols.