Evaluation of Efficacy and Safety of Combination of Narrow Band Ultraviolet B and Topical Calcipotriol Versus Narrow Band UVB alone in the Treatment of Vitiligo

Background: Narrow band Ultraviolet B (NBUVB) has been used successfully for the treatment of vitiligo. Recently, topical calcipotriol has also been used as immunotherapy or as a part of combination therapies. The aim of this study was to compare the clinical efficacy and safety of NBUVB and NBUVB plus topical calcipotriol in the treatment of generalized vitiligo. Methods: NBUVB phototherapy was given to 26 patients with generalized, symmetrical vitiligo three times weekly. Topical calcipotriol cream was only applied on the lesions located on one side of the body. Treatment was continued until cosmetically acceptable repigmentation occurred, but total cumulative dose of NBUVB did not increase from the mean of 113.4 ± 47.0 j/cm. The efficacy of treatment was evaluated by visually scoring the percentage of regimentation of the lesions at 12-session intervals by an investigator unaware of the side of calcipotriol application. Results: The mean daily dose of NBUVB was 1.4 ± 0.6 j/cm. The median number of exposure for initial regimentation was 26.5 (range 14-38) on the side of combination therapy with calcipotriol and 25.3 (range 20-40) on the other side. After 24 sessions of treatment, 14 patients (53.9%) showed minimal to moderate improvement on the calcipotriol treated side as compared to 21 patients ( 80.8 %) on the other side. After 60 sessions of treatment, 16 patients (16.5 %) showed moderate to marked regimentation on the side of combination therapy with calcipotriol as compared to 19 patients (73 %) on the other side. Conclusion: These findings indicate that concurrent use of topical calcipotriol does not enhance the efficacy of NBUVB in the treatment of vitiligo.