Needling: an adjunct to narrowband ultraviolet B therapy in localized fixed vitiligo
Keywords:
Needling, NBUVB, vitiligoAbstract
Background Treatment of vitiligo still remains a challenge. New modalities are added every now and then for non-responding patches. Needling is relatively recent addition. Objectives To assess the usefulness of needling as an adjunct to narrowband ultraviolet B therapy in non-responding, localized fixed vitiligo Patients and methods 23 adult cases (16 female and 7 male) having 84 localized vitiligo patches, who did not respond to medical measures either alone or in combination with ultraviolet exposures were available for evaluation at the end of study. After preliminary investigations, patients were subjected to needling of the involved sites. Many of them were trained to perform needling themselves. Patients were then treated with thrice weekly narrowband ultraviolet B (NBUVB) therapy. Results Almost 90 % patches showed good to excellent response after six months of needling with NBUVB exposures without much of side effects. Conclusion Needling is a safe, effective and promising adjunct treatment to NBUVB for repigmentation of non-responding localized vitiligo.References
Shah SA, Aftab S, Goplani S. Prevalence of vitiligo in skin clinic. J Pak Assoc Dermatol 1991; 1: 14-9.
Najoo MD, Westerhof W, Bos JD, Bossyuyt PMM. A systemic review of autologous transplantation methods in vitiligo. Arch Dermatol 1998; 134: 1543-9.
Millington GWM, Levell NJ. Vitiligo: the historical curse of depigmentation. Int J Dermatol 2007; 46: 990-5.
Flabella R, Arrunategui A, Barona MI, Alzate A. The minigrafting test for vitiligo: detection of stable lesions for melanocyte transplantation. J Am Acad Dermatol 1995; 32: 228-32.
Gottschalk GM, Kidson SH. Molecular analysis of vitiligo lesions reveals sporadic melanocyte survival. Int J Dermatol 2007; 46: 268-72.
Leite RMS, Leite AAC. Two therapeutic challenges: periocular and genital vitiligo in children successfully treated with pimecrolimus cream. Int J Dermatol 2007; 46: 986-9.
Grimes PE. Vitiligo: an overview of therapeutic approaches. Dermatol Clin 1993; 11: 325-8.
Drake LA, Dinehart SM, Farmer ER et al. Guidelines of care for vitiligo. J Am Acad Dermatol 1996; 35: 620-6.
Guerra L, Capurro S, Melchi F. Treatment of “stable” vitiligo by timed surgery and transplantation of cultured epidermal autografts. Arch Dermatol 2000; 136: 1380-9.
Savant SS. Introduction to vitiligo surgery. In: Savant SS, editors. Textbook of Dermatosurgery and Cosmetology, 2nd edn. Mumbai: ASCAD; 2005. P 336.
Yar M, Gilchrist B. Vitiligo. The revolution of cultured epidermal autografts and other surgical treatment modalities. Arch Dermatol 2001; 137: 348-9.
Savant SS. Therapeutic wounding. In: Savant SS, editors. Textbook of Dermatosurgery and Cosmetology. 2nd edn. Mumbai: ASCAD; 2005. p. 370-7.
Mutalik S, Ginzberg A. Surgical management of stable vitiligo: A review with personal experience. J Dermatol Surg 2000; 26: 248-54.
Savant SS. Surgical therapy of vitiligo: Current status. Ind J Dermatol Venereol, Leprol 2005; 71: 307-10.
