Nonsurgical Repigmentation Therapies in Vitiligo

Sixty-three studies were found ontherapies for localized vitiligo. Of these, 10 of 11 ran-domized controlled trials and 29 of 110 patient serieswere included. One hundred seventeen studies on thera-pies for generalized vitiligo were found. Of these, 10 of22 randomized controlled trials and 46 of 231 patientseries were included. Among randomized controlled tri-als on localized vitiligo, the pooled odds ratio vs placebowas significant for topical class 3 corticosteroids (14.32;95% confidence interval [CI], 2.45-83.72). In the patientseries, topical class 3 and class 4 corticosteroids carriedthe highest mean success rates (56% [95% CI, 50%-62%] and 55% [95% CI, 49%-61%], respectively). Sideeffects were reported mostly with topical psoralen andintralesional and class 4 corticosteroids. In the random-ized controlled trials on generalized vitiligo, the oddsratio vs placebo was significant for oral methoxsalenplus sunlight (23.37; 95% CI, 1.33-409.93), oral psor-alen plus sunlight (19.87; 95% CI, 2.37-166.32), andoral trioxsalen plus sunlight (3.75; 95% CI, 1.24-11.29).In the series, the highest mean success rates wereachieved with narrowband UV-B (63%; 95% CI, 50%-76%), broadband UV-B (57%; 95% CI, 29%-82%), andoral methoxsalen plus UV-A therapy (51%; 95% CI,46%-56%). Oral methoxsalen plus UV-A was associatedwith the highest rates of side effects. No side effects werereported with UV-B therapy.