Narrowband Ultraviolet B Phototherapy versus Excimer Laser in the Treatment of Vitiligo: A Retrospective Analysis

Vitiligo is an acquired autoimmune disorder of depigmentation with a global prevalence of 1%. Phototherapy with Narrowband Ultraviolet B (NBUVB) light and excimer laser are both FDA approved treatments for vitiligo. Studies comparing the two modalities are few in patients with different skin colors. Aim: To compare the efficacy and safety of NBUVB versus excimer laser in vitiligo in terms of re-pigmentation achieved during treatment and side effects. Materials and Methods: This study was a retrospective chart review of vitiligo patients attending the phototherapy unit from January 2016 to August 2018. Patient profiles including age, gender, site and extent of vitiligo, type of phototherapy treatment (NBUVB vs excimer laser), sessions per week, sessions required for onset of repigmentation, sites of repigmentation, and side effects were noted. Qualitative variables were analysed using Chi-square test. Quantitative variables were analysed using mean and Standard Deviation (SD). A p-value of <0.05 was considered statistically significant. Results: A total of 146 patients aged 4-70 years were included. Ninety-six patients received excimer laser and 50 patients were on NBUVB. Initial repigmentation occurred after a mean±SD of 28.91±16.61 sessions in the NBUVB group and 24.26±17.57 sessions in the excimer laser group. The difference was not statistically significant (p=0.18). Repigmentation occurred faster on the face followed by the trunk in both groups. Side effects were higher with excimer laser compared to NBUVB (90.6% versus 76%) and the difference was statistically significant (p=0.017). Side effects were, however, mild and did not warrant treatment discontinuation. Conclusion: Number of sessions required for onset of repigmentation was similar in both groups. Side effects, although more frequent with excimer laser, were mild and required dose reduction rather than discontinuation of treatment.