Non Segmental Vitiligo in Children: Treatment with Narrow Band Ultraviolet B With and Without Topical 5 Fluorouracil on Ablated Lesions | ||||
| Minia Journal of Medical Research | ||||
| Article 54, Volume 30, Issue 3, July 2019, Page 253-261 PDF (538.02 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2022.221957 | ||||
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| Authors | ||||
| Tag El-din El. Anbar1; Basma A. Ali2; Aliaa M. Monir3; Lamyaa G. Abd El-Razek1 | ||||
| 1Department of Dermatology, Faculty of Medicine, Minia university. | ||||
| 2Department of Pediatric, Faculty of Medicine, Minia university. | ||||
| 3Department of Clinical Pathology, Faculty of Medicine, Minia university | ||||
| Abstract | ||||
| Introduction: Vitiligo is a chronic idiopathic pigmentary disorder of the skin and hair, it is common in children below 12 years and its Management in children is difficult as therapeutic options are restricted when compared to that in adult patients. NB-UVB is an effective modality in the treatment of vitiligo with high success rates and low incidence of side effects and it is effective in childhood vitiligo. Skin ablation by mechanical dermabrasion with 5Fluorouracil (5FU) was introduced to treat vitiligo in 1983. This was modified replacing the mechanical dermabrasion by Erbium-YAG (ER:YAG) laser ablation and resulted in better prognosis in periungual vitiligo. The Aim of the study: Exploring the effect of the use of ER-YAG laser ablation plus application of topical 5FU on the outcome of short term NB-UVB phototherapy for children having non segmental vitiligo (NSV) and exploring safety of topical 5FU on this age group. Patients and Methods: The study was a left – right comparative study that included 22 children with non-segmental vitiligo (NSV), attending the Dermatology Outpatient Clinic of Minia University Hospital. This study included 22 child with a total of 22-paired symmetrical non segmental vitiligo lesions in different body parts and their ages ranging from 8-12 year. The treated sides were divided in to 2 groups: Group (A): included the 22 right sides of the body in the children that will subjected to ER-YAG laser plus 5FU before simultaneous NBUVB therapy of both sides. Group (B) included the 22 left sides of the body in the same children that will subjected to NB-UVB phototherapy only. They were 9 (40.9%) females and 13 (59.1%) males with 22 paired vitiligo lesions in different body sites. Each pair was more or less symmetrical.They were collected during the period from March 2014 to April 2016. Results: The overall response to therapy was better using the combination therapy. (81.9%) of patients experienced a moderate to marked repigmentation response in the combination group compared with 0% of patients showed marked response and 13.6% showed moderate response in the mono-therapy group. In different body parts the response was significantly higher in lower limbs and feet but statistically insignificant in other body parts. Transient hyperpigmentation occurred in 3 cases and no koebnerization detected in any of the treated lesions. Conclusion: This study concluded that prior use of ER:YAG laser skin ablation, followed by 5FU application before NB-UVB phototherapy for non segmental vitiligo in children is a safe and tolerable technique that improves the outcome of short-term NB-UVB therapy and proved the safety of 5FU cream in this age group when applied to limited areas. | ||||
| Keywords | ||||
| Non Segmental Vitiligo; Children; Narrow Band Ultraviolet B; 5 Fluorouracil | ||||
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