The Effect of Narrow Band Ultra Violet B Rays Alone Versus its Combination with Intra lesional Injection of Latanoprost in the Treatment of Vitiligo

Abstract

Background: Vitiligo depigmentation is considered to be a consequence of melanocyte disappearance mediated by the immune system, toxic materials oroxidative stress.The pigmentary effect of three analogues of prostaglandin F2α (PGF2α) (latanoprost, bimatoprost, and travoprost) on normal skin of guinea pigs was found to be effective and promising interactive treatment. The gold standard for treatment of diffuse vitiligo is now known to be NBUVB (310-315) radiation.

Aim of the study: The aim of this study wasto compare the effect of NBUVB rays alone and combined with intra lesional injection of latanoprost in the treatment of vitiligo to evaluate the role of latanoprost in treatment of vitiligo.

Patients and methods:A total number of 40 patients with vitiligo were included in the study. They were collected from out-patient clinic of Dermatology, Venereology and Andrology department, Faculty of Medicine, Zagazig University, in the period from November 2019 to November 2020 after obtaining the approval of the institutional review board (IRB) of Zagazig University. They were divided into 2 groups each of 20 patients. The first group received 2 sessions of NBUVB rays per week as a single treatment and the second group received also 2 sessions of NBUVB rays in addition to intra lesional injection of latanoprost once weekly both for 6 months duration.

Results:Regarding differences in each group pre & post treatment there was a decrease in score in group I by 16.82% after treatment but without statistical significance while in group II there was a statistically significant decrease in disease score after treatment by 53.86%. The degree of repigmentation with NBUV+latanoprost ranged from 0 – 95%, while with the NB-UVB treated patients, the degree of repigmentation ranged from 0 – 60%. There was a statistically significant increase in degree of repigmentation in group II compared to group I.During follow up, there was an increase in the disease score among group I compared to group II after 3 months from the end of treatment sessions but without statistical significance.

Conclusion:This study demonstrated that intradermal injection of PG F2α enhanced the outcome of NB-UVB as regard rate and degree of repigmentation of lesions in vitiligo.