Topical calcipotriol versus oral psoralen-UVA (PUVA) and topical calcipotriol in the treatment of vitiligo in type IV skin

Background The treatment of vitiligo is a challenging task. Several therapeutic modalities have been tried till date. Topical calcipotriol alone and in conjunction with PUVA have shown good results in various international studies in the treatment of type I & II vitiliginous skin. Objective Our aim was to evaluate and compare the efficacy of topical calcipotriol alone and in combination with PUVA in the treatment of vitiligo in type IV skin. Patients and methods Sixty patients of vitiligo (26 males & 34 females), aged 12-60 years and involving < 30% of the body surface area were enrolled and randomly divided into two equal groups. Group I patients were treated with twice daily application of topical calcipotriol for six months. In group II patients, in addition to topical calcipotriol, photochemotherapy (PUVA) was advised thrice a week for the same duration. Response was graded according to the degree of repigmentation. Results In group I, only one sixth (16.7 %) of the cases responded and all of them had less than 50% repigmentation whereas in group II, all the patients responded. Seventy percent of the cases in this group showed excellent response (> 75% of repigmentation). Conclusion We conclude that topical calcipotriol alone has no role in the treatment of vitiligo in type IV skin but when combined with PUVA leads to an excellent response in greater than two third of the patients.