Comparative Study between the Efficacy of Trichloroacetic Acid 30% versus Intradermal 5 Fluorouracil Injection in Treatment of Vitiligo with or without Narrow Band Ultraviolet B Phototherapy

Background: Vitiligo is a challenging disease, which significantly impaired quality of life (QoL). In recent years, there are numerous therapeutic modalities available that aim to stop progression with a subsequent induction of skin re-pigmentation. Combination among different modalities could improve the response, reduces the adverse events, and reduces the course required to achieve re-pigmentation in vitiligo.
Objective: To compare the efficacy of trichloroacetic acid (TCA) chemical peel (30% concentration) versus intradermal injection of 5 Fluorouracil Injection (5-FU) both with and without Narrow Band Ultraviolet B (NB-UVB) Phototherapy (PT) in management of stable non-segmental vitiligo (NSV).
Patients and Methods: This comparative prospective interventional study comprised 60 patients with stable NSV. Patients were divided into two equal groups: Group I and group II. Lesion 1 in both groups was treated with only TCA 30%, while, lesion 2 was treated with only intradermal injection of 5-FU. In group II, each lesion was followed by the application of NBUVB sessions twice/week.
Results: Based on the Physician's Global Assessment (PGA) score, the present study demonstrated a highly statistically significant increase in the percentage of improvement among group II compared to group I. According to the PGA score, our study demonstrated a statistically significant increase in the percentage of improvement among the subgroup 5-FU II+ NBUVB compared to 5-FU I.
Conclusion: It could be concluded that the combination therapies of each of TCA or 5-FU with NBUVB ranked higher than monotherapy with either TCA or 5-FU in inducing successful re-pigmentation in stable NSV patients.