Vitiligo: Prevalence, clinical patterns, and efficacy of narrow band ultraviolet B phototherapy

Abstract

Background: Vitiligo denotes an acquired primary, usually progressive, melanocytopenia of unknown etiology, and clinically manifested by circumscribed achromic macules often associated with leukotrichia. Objective: The objective was to assess the prevalence and various clinical patterns of vitiligo and to study the efficacy of narrow-band ultraviolet B (NB-UVB) radiation. Materials and Methods: A prospective case series study was carried out at dermatology outpatient department (OPD), of tertiary care center in Central India on 50 patients of Vitiligo, who were diagnosed clinically, age ranging from 5 to 70 years of age. A thorough history and clinical examination as per institutional protocol was done for all the patients included in the study. Patients were exposed to NB-UVB rays in a phototherapy unit (Dermaindia Spiegel Series) with a standard protocol. Two scores designed for the assessment of vitiligo are Vitiligo Area Severity Index and Wallace Rule of Nines. Results: During the period of two years, 6638 patients were seen in dermatology OPD, out of which 129 patients were having vitiligo clinically. Thus, the prevalence of vitiligo was 1.9% in our study. The mean age in male was 40.4 years and that of female was 30.85 years. The female-to-male ratio was 2:3. 6% had a positive family history of vitiligo. The most common site affected was leg (pretibial region) (48%). Two patients (4%) were in Category– 0, 12 patients (24%) were in Category– I, 24 patients (48%) were in Category-II, and 12 patients (24%) were in Category– III, when graded according to their improvement. Forty-five patients (90%) had vitiligo vulgaris, two patients (4%) had segmental vitiligo, and one patient (2%) each of acrofacial vitiligo, lip-tip vitiligo, and focal vitiligo. On comparing the level of significance before treatment and after 2 months of treatment, after 4 and 6 months of treatment, and before treatment and at the end of treatment, it was found that the results were statistically highly significant. Thus, indicating that the improvement in the disease after NB-UVB therapy is statically significant. Conclusion: Our study found 1.9% prevalence of vitiligo among patients attending OPD. On comparing the level of significance, before treatment and at the end of treatment, it was found that the results were statistically highly significant with respect to improvement. Side effects were minimal in our participants. Thus, our study concludes that NB-UVB radiation is an effective and safe therapy for vitiligo.