Comparison of effectiveness and safety of narrow band ultraviolet B with and without platelet rich plasma in the treatment of vitiligo
DOI:
https://doi.org/10.66344/jpad.v34i4(Suppl).3071Keywords:
Effectiveness, safety, narrow band ultraviolet B, Vitiligo, Platelet rich plasmaAbstract
Objective To compare efficacy and safety of Narrow Band Ultraviolet B with and without platelet rich plasma in the treatment of vitiligo.
Methods A total of 74 patients took part in the trial who were randomly divided in two groups (37 in each group). Patients in Group-A were given NBUVB alone, whereas those in Group-B were given both NBUVB and PRP. The NB-UVB treatment protocol included twice-weekly sessions for up to three months, or until complete re-pigmentation had occurred. Patients in Group B had fortnightly PRP treatment for a total of 6 sessions over the course of 3 months. PRP was injected intradermally into the lesion. After the final session, the patients were followed up with for an additional month.
Results Vitiligo patients benefited more from the NBUVB+PRP combination than from NBUVB alone. The effectiveness was statistically significant in group B (Group A: 64.9% vs. Group B: 91.9%, p-value=0.005). 35.1% of Group-A patients and 59.5% of Group-B patients achieved excellent treatment outcomes, according to evaluation criteria for effectiveness. While 30 percent of Group-A patients and 32 percent of Group-B patients had good treatment outcome, 35 percent of patients in Group-A and 8 percent in Group-B experienced moderate outcome. Both the treatments were safe and no serious or long-term adverse effects were noted.
Conclusion This study's findings suggested that platelet-rich plasma (PRP) combined with narrowband ultraviolet B (NB-UVB) was a better therapy for vitiligo than NB-UVB alone. This treatment for vitiligo was cost-effective, risk-free, and well-tolerated. It reduced the time spent in NB-UVB treatment, which should improve adherence.
References
1. Razmi T M, Parsad DJPSD. Recent advances in pathogenesis and medical management of vitiligo. Pigmentary Skin Disorders Updates in Clinical Dermatology. 2018:123-38.
2. Zhang Y, Cai Y, Shi M, Jiang S, Cui S, Wu Y, et al. The prevalence of vitiligo: a meta-analysis. PLoS ONE. 2016;11(9):e0163806.
3. Van Driessche F, Silverberg NJPD. Current management of pediatric vitiligo. Paediatr Drugs. 2015;17:303-13.
4. Kandaswamy S, Akhtar N, Ravindran S, Prabhu S, Shenoi SDJIjod. Phototherapy in vitiligo: assessing the compliance, response and patient's perception about disease and treatment. Indian J Dermatol. 2013;58(4):325.
5. Rekik M, Mseddi M, Kammoun N, Sellami K, Turki H. Efficacy of autologous platelet-rich plasma in the treatment of vitiligo: A 10-patient prospective study. J Cosmet Dermatol. 2022;21(10):4225-33. doi: 10.1111/jocd.15050.
6. Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui HJAoD. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol. 2004;140(6):677-83.
7. Arora AK, Dogra SJPI. Narrowband ultraviolet B and beyond: Evolving role of phototherapy in vitiligo. Photodermatol Photoimmunol Photomed. 2015;2(1):9.
8. Yuksel EP, Sahin G, Aydin F, Senturk N, Turanli AYJJoC, Therapy L. Evaluation of effects of platelet-rich plasma on human facial skin. J Cosmet Laser Ther. 2014;16(5):206-8.
9. Cameli N, Mariano M, Cordone I, Abril E, Masi S, Foddai MLJDS. Autologous pure platelet-rich plasma dermal injections for facial skin rejuvenation: clinical, instrumental, and flow cytometry assessment. Dermatol Surg. 2017;43(6):826-35.
10. Dhurat R, Sukesh MJJoc, surgery a. Principles and methods of preparation of platelet-rich plasma: a review and author's perspective. J Cutan Aesthet Surg. 2014;7(4):189.
11. Ibrahim ZA, El-Ashmawy AA, El-Tatawy RA, Sallam FA. The effect of platelet-rich plasma on the outcome of short-term narrowband-ultraviolet B phototherapy in the treatment of vitiligo: a pilot study. J Cosmet Dermatol. 2016;15(2):108-16.
12. Rashighi M, Harris JE. Vitiligo pathogenesis and emerging treatments. Dermatologic Clinics. 2017;35(2):257-65.
13. Salem SAM, Fezeaa TA, El Khazragy N, Soltan MY. Effect of platelet-rich plasma on the outcome of mini-punch grafting procedure in localized stable vitiligo: clinical evaluation and relation to lesional basic fibroblast growth factor. Dermatol Ther. 2021;34(2):e14738.
14. Parambath N, Sharma VK, Parihar AS, Sahni K, Gupta S. Use of platelet-rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double-blind randomized controlled trial. Int J Dermatol. 2019;58(4):472-6.
15. Khattab FM, Abdelbary E, Fawzi M. Evaluation of combined excimer laser and platelet-rich plasma for the treatment of nonsegmental vitiligo: a prospective comparative study. J Cosmet Dermatol. 2020;19(4):869-77.
16. Chen J, Wan Y, Lin Y, Jiang H. Current art of combination therapy with autologous platelet-rich plasma for stable vitiligo: a meta-analysis. Int Wound J. 2021;18(3):251-60.
17. Shih S. Platelet-rich plasma: Potential role in combined therapy for vitiligo. Dermatol Ther. 2019;32(1):e12773.
18. Afify AA, Zuelfakkar NM, Eshafi MA. Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (a randomized clinical trial). Lasers Med Sci. 2021;36(7):1479-86.
19. Yin L, Adotama P, Svigos K, Gutierrez D, Sicco KL. Platelet-rich plasma, a promising adjunctive treatment for vitiligo: a case report. JAAD Case Rep. 2020;6(12):1320-2.
20. Esquivel D, Mishra R, Srivastava A. Stem cell therapy offers a possible safe and promising alternative approach for treating vitiligo: a review. Curr Pharm Des. 2020;26(37):4815-21.
21. Nagata MJH, Messora MR, Furlaneto FAC, et al. Effectiveness of two methods for preparation of autologous platelet-rich plasma: an experimental study in rabbits. Eur J Dent. 2010;4(4):395-402.
22. Carrillo-Mora P, González-Villalva A, Macías-Hernández SI, Villaseñor CP. Platelets-rich plasma: a versatile tool for regenerative medicine? Cir Cir. 2013;81(1):74-82.
23. Tun KM, Juntongjin P, editors. Efficacy of platelet-rich plasma in combination therapy for vitiligo. International Research Conference; 2020: Rangsit University.
24. Tawfik YM, Abd ELazim NE, Bakr RM, Abdel-Khalek LA, Gomaa AS. Management of acral vitiligo using Narrow band UVB, microneedling with and without platelet rich plasma. 2023. 10.21203/rs.3.rs-2648905/v1.
25. Kale MS, Chavan DD, Jamale VP, Nikam BP, Hussain A, Rai R, et al. To compare the safety & efficacy of platelet rich plasma therapy plus narrowband ultravoilet B (NBUVB) therapy versus narrowband ultravoilet B therapy alone in the treatment of vitiligo–a double blind, randomised controlled study. J Med Sci Clin Res. 2019;7(3):314-21.
26. Elsaadany AE, El‐Khalawany M, Elshahid AR, Seddeik Abdel‐Hameed AK. Comparison between 308‐nm excimer light alone versus 308‐nm excimer light and platelet‐rich plasma in the treatment for localized vitiligo. J Cosmet Dermatol. 2022;21(7):2826-31.
27. Abdelghani R, Ahmed NA, Darwish HM. Combined treatment with fractional carbon dioxide laser, autologous platelet‐rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: a prospective, randomized comparative trial. J Cosmet Dermatol. 2018;17(3):365-72.
28. Bashir F, Shaheen G, Tahir K, Amin U, Naveed A, Tahir M. Efficacy of fractional carbon dioxide laser and platelet rich plasma versus fractional carbon dioxide laser alone in patients of vitiligo. J Pak Assoc Dermatol. 2024;34(1):123-9.
29. Pandey AK, Mohan A, Satyaraj P. Comparative study of narrowband-ultraviolet B plus intralesional normal saline versus narrowband-ultraviolet B with platelet rich plasma in treatment of vitiligo. Int J Res Dermatol. 2023;9(4):175-81
30. Fawzy M, Al-Mokadem S, Alshereef M, Elkholy B. Narrowband ultraviolet B phototherapy combined with intralesional injection of either latanoprost or platelet-rich plasma for stable nonsegmental vitiligo. Photodermatol Photoimmunol Photomed. 2024;40(1):e12929.
doi: 10.1111/phpp.12929. Epub 2023 Nov 20. PMID: 37984828.
31. Mahajan R, Ninama K, Shah H, Bilimoria F. Effect of intralesional platelet rich plasma in chronic localized vitiligo. Int J Res Dermatol. 2018;4(4):550-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Shehla Shaukat, Tayyaba Riaz, Mahwish Zahoor, Amina Afzal, Syed Ahmed Ali Gardezi, Ghazala Butt, Ijaz Hussain
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
