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Results of the HI‐Light Vitiligo Trial: a clinical trial of corticosteroid ointment and home‐based narrowband ultraviolet light for vitiligo
Publication year - 2021
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19908
Subject(s) - vitiligo , medicine , dermatology , clinical trial , topical steroid , ultraviolet light , ultraviolet b , population , randomized controlled trial , surgery , environmental health , photochemistry , chemistry
Vitiligo is a skin condition that causes loss of pigment (white patches) on the skin. It affects 1–2% of the world’s population. The HI‐Light Vitiligo Trial aimed to find out whether treating vitiligo at home with a particular type of ultraviolet light (NB‐UVB), either by itself or with a steroid ointment, is better than treatment using a steroid ointment on its own. We enrolled into the study 517 children and adults in the UK, who had small, recently changing patches of vitiligo. Participants received one of three possible treatment options: steroid ointment, handheld NB‐UVB light, or both treatments used together. We asked participants to judge how noticeable a ‘target’ vitiligo patch was after 9 months of treatment. We considered the treatment to be successful if they thought it was either ‘a lot less noticeable’ or ‘no longer noticeable’. They could treat other patches as well. Using both treatments together was better than using steroid ointment on its own: over one‐quarter of participants (27%) who used both treatments together said that their vitiligo was either ‘no longer noticeable’ or ‘a lot less noticeable’ after 9 months of treatment. This is compared with 17% of those using steroid ointment on its own and 22% of those using NB‐UVB light on its own. All treatments were able to stop the vitiligo from spreading. Patches on the hands and feet were less likely to respond to treatment than patches on other parts of the body. The trial found that the vitiligo tended to return once treatments were stopped. The treatments were relatively safe and easy to use, but light treatment required a considerable time commitment (approximately 20 minutes per session, two to three times per week). In this trial, we found that using steroid ointment and NB‐UVB light together is likely to be better than steroid ointment alone, for people with small patches of vitiligo. Steroid ointment alone can still be effective for some people and remains a useful first treatment. The challenge is to make handheld NB‐UVB light treatment available as normal care for people with vitiligo. Linked Article: Thomas et al. Br J Dermatol 2021; 184 :828–839.