Efficacy of Topical Corticosteroid vs PUVAsol Following Split Thickness Grafting in Stable Vitiligo: A Randomised Control Trial

This is the authors' abstract. We don't add key points for this paper.

Background: Vitiligo is a common, acquired, discoloration of the skin, characterized by well circumscribed, ivory or chalky white macules which are flush to the skin surface. Although majority of cases are managed by medical therapies, surgical methods are reserved for lesions not responding to medical treatment and are stable in nature. The basic principle surgical method is the transfer of melanocytes from uninvolved skin to the stable vitiligo patch in the form of either tissue graft or cellular graft. Purpose: To evaluate the effects of topical corticosteroids and PUVAsol in repigmentation of vitiligo patch following split-thickness skin grafting. Methods: Twenty patients of stable vitiligo having total 30 patches were included in the study of which 15 completed it. Each patch is subjected to split-thickness skin grafting and then randomly divided into two groups of fifteen each. Group A received PUVAsol therapy while other received topical steroid therapy started 4 weeks after surgery. During the follow-up of 6 months, five patients were lost to follow-up; fifteen patients were evaluated for pigment spread and side effects at 1 st , 4 th , 8 th , and 24 th week. Results: Eight patients (61.53%) in PUVA sol group and seven patients (58.3%) in steroid group had excellent (>90%). Color matching of grafted area was observed to be better with steroid therapy (83.3%), then PUVAsol (76.9%). Conclusion: Although the extent of repigmentation was more in Group A (PUVAsol) then in Group B, the color matching and the side effect profile were improved in Group B (topical steroid). The use of topical corticosteroid is much less cumbersome, cheaper, and easy to administer at home. The limitation of our study was short follow-up and small sample size.