Trichloroacetic Acid Peel 15% + NB-UVB Versus Trichloroacetic Acid Peel 25% + NB-UVB for Stable Non-Segmental Vitiligo

Apart from the famously known Koebner's phenomenon in vitiligo patients (development of isomorphic lesions at traumatized uninvolved skin of patients with cutaneous diseases), [2] it is widely known that there is wound-associated pigmentation in normal individuals. The latter could be explained by two major processes; the first is incontinentia pigmenti, which occurs after destroying the basal cell layer resulting in accumulation of melanophages in the upper dermis, whereas the other process involves an epidermal inflammatory response induced by injury ranging from early tyrosine kinase induction to the late upregulation of growth factors, proteases, and extracellular matrix components, resulting in the release and oxidation of arachidonic acid to prostaglandins and leukotrienes. These mediators alter the activity of melanocytes and immune cells. This leads to increase in the synthesis of melanin and transfer of pigment to surrounding keratinocytes [3] .