Efficacy of microneedling combined with calcipotriol plus betamethasone in the treatment of vitiligo

Authors

  • Saima Manzoor Dermatologist, Ultracare Hospital, Wapda Town, Gujranwala
  • Anum Sadia Department of Dermatology, Sir Ganga Ram Hospital, Lahore.
  • Madiha Siddique Department of Dermatology, Social Security Hospital Gujranwala
  • Ayesha Mumtaz Department of Dermatology, Khawaja Arshad Family Hospital, Sargodha
  • Nadia Ali Azfar Department of Dermatology, Allama Iqbal Medical College, Jinnah Hospital Lahore
  • Rabia Hayat Department of Dermatology, Fatima Jinnah Medical University/ Sir Ganga Ram Hospital, Lahore

Keywords:

Betamethasone, Calcipotriol, VASI Score, Microneedling, Vitiligo

Abstract

Background: Vitiligo presents with the loss of skin, mucosa, and hair pigmentation, often progressing as melanocytes are selectively lost. Current treatments aim to halt its advancement and restore pigmentation by addressing functional deficits in affected areas. However, no single treatment is universally effective, leading to the adoption of combined approaches based on individual cases. A recent study proposed microneedling with calcipotriol and betamethasone as promising for improving the condition, yet further research is needed due to limited evidence. This study aims to address this gap and provide more clarity on the efficacy of such a combination therapy.   Objective: To assess the outcome of microneedling combined with calcipotriol plus betamethasone (measured by mean change in VASI) in the treatment of vitiligo. Methodology: This study involved 57 patients of both genders aged between 15-45 years presenting with vitiligo enrolled after taking informed written consents. These patients were assessed by VASI score before starting treatment. Treatment was given in the form of microneedling combined with calcipotriol plus betamethasone. VASI score was reassessed 2 weeks after 3 months of treatment. Outcome variable was mean change in VASI score which was measured by subtracting the follow-up VASI score from that at baseline and compared across various subgroups of studied patients. Results: Mean age of the patients was 26.4±8.9 years. There were 26 (45.6%) male and 31 (54.4%) female patients. Mean duration of disease was 4.56±1.71 years. Family history of vitiligo was present in 16 (28.1%) patients. The mean change in VASI score from baseline was 39.65±4.97. Mean change in VASI score across various subgroups of patients had insignificant difference (p-value>0.05). Conclusion: Microneedling combined with calcipotriol and betamethasone was associated with considerable mean change in VASI score in vitiligo patients which owing to safety and simplicity of treatment advocates its preferred use in managing such patients in future dermatological practice.   KEY WORDS: Betamethasone, Calcipotriol, Microneedling, VASI Score, Vitiligo.

References

Joge RR, Kathane PU, Joshi SH. Vitiligo: a narrative review. Cureus. 2022;14(9):e29307. doi:10.7759/cureus.29307

Santosh SK, Sushantika I, Mohan L, Gupta AK, Mohammad A, Kumar N. Treatment of Vitiligo with 5-fluorouracil after microneedling of the lesion. Int J Sci Stud. 2018;5(11):125-7.

Husain MA, Alam MN, Rahim R, Joarder Y, Wahidujjaman, Ferdous M. Efficacy and safety of topical tacrolimus (0.03%) in the treatment of localized vitiligo. Med Today. 2017;29(1):1-5.

Bilal A, Shiakh ZI, Khan S, Iftikhar N, Anwar 1, Sadiq S. Efficacy of 0.1% topical tacrolimus with narrow band ultraviolet B phototherapy versus narrow band ultraviolet B phototherapy in vitiligo. J Pak Assoc Dermatol. 2014;24(4):327-31.

Zaib SR, Rashid S, Faraz AAK. To assess the efficacy of topical 0.03% tacrolimus ointment in the treatment of vitiligo. Pak J Med Health Sci 2017;11(2):616-9.

Chhabra S, Chahar YS, Singh A. A comparative study of microneedling combined with topical 5-fluorouracil versus microneedling alone in treatment of localized stable vitiligo. Indian J Dermatol. 2021;66(5):574-80.

Zeid OM, Omar N, El Sharkawy D. The efficacy of combining fractional CO2 laser and tacrolimus ointment in the treatment of vitiligo. J Egypt Women Dermatol Soc. 2020;17(1):25- 30.

Sardana K, Verma G. Overview of medical therapies and phototherapy in vitiligo based on their pathogenetic action and the role of platelet-rich plasma. J Cutan Aesthet Surg. 2018;11:167-8. doi:10.4103/JCAS.JCAS_68_17

Mumtaz H, Anis S, Akhtar A, Rubab M, Zafar A, Niazi N, et al. Efficacy of tacrolimus versus clobetasol in the treatment of vitiligo. Cureus. 2020;12(12):e11985. doi: 10.7759/cureus.11985

Abd‐Elazim NE, Yassa HA, Mahran AM. Microdermabrasion and topical tacrolimus: A novel combination therapy of vitiligo. J Cosmet Dermatol. 2020;19(6):1447-55. doi:10.1111/jocd.13193

Zahoor M, Shaukat S, Khan MS, Ahmad TJ. Comparison of efficacy and safety of 0.005% calcipotriol ointment versus 0.05% betamethasone dipropionate ointment versus calcipotriol plus betamethasone ointment for the treatment of vitiligo. J Pak Assoc Dermatol. 2017;27(1):30-6.

Saldanha KD, Machado Filho CD, Paschoal FM. Action of topical mometasone on the pigmented halos of micrografting in patients with vitiligo. Ann Bras Dermatol. 2012;87:685-90. doi:10.1590/s0365-05962012000500002

Alam MN, Wahab MA, Khondker L, Khan MSI. Comparative efficacy and safety of the combination of betamethasone dipropionate and calcipotriene with topical betamethasone dipropionate and calcipotriene alone in the treatment of localized vitiligo. J Pak Assoc Dermatol. 2014;24(2):143-9.

Habib A, Raza N. Clinical pattern of vitiligo. J Coll Physicians Surg Pak. 2012;22(1):61-2.

Ibrahim ZA, Hassan GF, Elgendy HY, Al-Shenawy HA. Evaluation of the efficacy of transdermal drug delivery of calcipotriol plus betamethasone versus tacrolimus in the treatment of vitiligo. J Cosmet Dermatol. 2019;18(2):581-8. doi: 10.1111/jocd.12704

Zandi S, Farajzadeh S, Saberi N. Effect of vitiligo on self-reported quality of life in Southern part of Iran. J Pak Assoc Dermatol. 2016;21(1):4-9.

Kumaran MS, Kaur I, Kumar B. Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo. J Eur Acad Dermatol Venereol. 2006;20:269-73. doi: 10.1111/j.1468-3083.2006.01420.x

Dogan AS, Atacan D, Durmazlar SPK, Acar M, Gurdal C. Evaluation of dry eye findings in patients with vitiligo. Pak J Med Sci. 2015;31(3):587-91. doi: 10.12669/pjms.313.6926

Al-Fahaad HA. Clinico-epidemiological profile of vitiligo patients in Najran Region, Saudi Arabia. J Dermatol Surg. 2015;19(1):31-5.

Downloads

Published

2024-12-31

How to Cite

1.
Manzoor S, Sadia A, Siddique M, Mumtaz A, Azfar NA, Hayat R. Efficacy of microneedling combined with calcipotriol plus betamethasone in the treatment of vitiligo. J Pak Assoc Dermatol [Internet]. 2024Dec.31 [cited 2025Feb.16];34(4 Suppl.):S25-S30. Available from: https://jpad.com.pk/index.php/jpad/article/view/2970

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 3 4 > >>