Comparison of effectiveness and safety of narrow band ultraviolet B with and without platelet rich plasma in the treatment of vitiligo

Authors

  • Shehla Shaukat KEMU/ Mayo Hospital Lahore
  • Tayyaba Riaz Department of Dermatology, KEMU/ Mayo Hospital, Lahore
  • Mahwish Zahoor Department of Dermatology, KEMU/ Mayo Hospital, Lahore
  • Amina Afzal Department of Dermatology, KEMU/ Mayo Hospital, Lahore
  • Syed Ahmed Ali Gardezi Department of Dermatology, Sahiwal Medical College, Sahiwal
  • Ghazala Butt Department of Dermatology, KEMU/ Mayo Hospital, Lahore
  • Ijaz Hussain Department of Dermatology, KEMU/ Mayo Hospital, Lahore

Keywords:

Effectiveness, safety, narrow band ultraviolet B, Vitiligo, Platelet rich plasma

Abstract

Background: A number of therapies have been proposed, with varying degrees of success. Platelet-rich plasma (PRP) has gained popularity in recent decades as a potentially successful therapy for a variety of dermatological conditions, including vitiligo. There was no local investigation on the combination of PRP and Narrow Band Ultraviolet B for the treatment of vitiligo. Objective: To compare efficacy and safety of Narrow Band Ultraviolet B with and without platelet rich plasma in the treatment of vitiligo.              Methods: The study lasted for six months and was undertaken by the Department of Dermatology at KEMU in Lahore. A total of 74 patients are part in the trial (37 in each group). There were two types of patients analyzed. Patients in Group-A were given just NBUVB, whereas those in Group-B were given both NBUVB and PRP. The NB-UVB treatment protocol included twice-weekly sessions for up to three months, or until complete repimentation had occurred in all patients.  PRP was injected intradermally into the lesion using an insulin syringe. Injection sites were separated by 2 centimetres, and 0.1 cc of PRP was administered at each site. Patients in Group B had this treatment for a total of 6 sessions over the course of 3 months, with each session occurring every 2 weeks. After the final session, the patients were followed up with for an additional month. According to the clinical definition, the therapy was found to be effective and safe. The researcher personally gathered all of the information using standardised forms. Results: Vitiligo patients benefited more from the NBUVB+PRP combo than from NBUVB alone. For example, Success Rates (Group A: 64.9% vs. Group B: 91.9%, p-value=0.005) Only 35.1% of Group-A patients and 59.5% of Group-B patients achieved excellent treatment outcomes, according to evaluation criteria for efficacy. While 29.7 percent of Group-A patients and 32.4 percent of Group-B patients had good treatment outcome, 35.1 percent of patients in Group-A and 8.1% in Group-B experienced moderate outcome. Conclusion: This study's findings suggest that platelet-rich plasma (PRP) combined with narrowband ultraviolet B (NB-UVB) is an improved therapy for vitiligo over NB-UVB alone. This treatment for vitiligo is low-cost, straightforward, risk-free, and well-tolerated. It reduces the time spent in NB-UVB treatment, which should improve adherence.

Author Biography

Shehla Shaukat, KEMU/ Mayo Hospital Lahore

Assistant professor, dermatology unit -1, KEMU/mayo hospital, lahore

References

Razmi T M, Parsad DJPSD. Recent advances in pathogenesis and medical management of vitiligo. Pigmentary Skin Disorders Updates in Clinical Dermatology. 2018:123-38.

Zhang Y, Cai Y, Shi M, Jiang S, Cui S, Wu Y, et al. The prevalence of vitiligo: a meta-analysis. PLoS ONE. 2016;11(9):e0163806.

Van Driessche F, Silverberg NJPD. Current management of pediatric vitiligo. Paediatr Drugs. 2015;17:303-13.

Kandaswamy S, Akhtar N, Ravindran S, Prabhu S, Shenoi SDJIjod. Phototherapy in vitiligo: assessing the compliance, response and patient's perception about disease and treatment. Indian J Dermatol. 2013;58(4):325.

Rekik M, Mseddi M, Kammoun N, Sellami K, Turki H. Efficacy of autologous platelet-rich plasma in the treatment of vitiligo: A 10-patient prospective study. J Cosmet Dermatol. 2022;21(10):4225-33. doi: 10.1111/jocd.15050.

Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui HJAoD. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol. 2004;140(6):677-83.

Arora AK, Dogra SJPI. Narrowband ultraviolet B and beyond: Evolving role of phototherapy in vitiligo. Photodermatol Photoimmunol Photomed. 2015;2(1):9.

Yuksel EP, Sahin G, Aydin F, Senturk N, Turanli AYJJoC, Therapy L. Evaluation of effects of platelet-rich plasma on human facial skin. J Cosmet Laser Ther. 2014;16(5):206-8.

Cameli N, Mariano M, Cordone I, Abril E, Masi S, Foddai MLJDS. Autologous pure platelet-rich plasma dermal injections for facial skin rejuvenation: clinical, instrumental, and flow cytometry assessment. Dermatol Surg. 2017;43(6):826-35.

Dhurat R, Sukesh MJJoc, surgery a. Principles and methods of preparation of platelet-rich plasma: a review and author's perspective. J Cutan Aesthet Surg. 2014;7(4):189.

Ibrahim ZA, El-Ashmawy AA, El-Tatawy RA, Sallam FA. The effect of platelet-rich plasma on the outcome of short-term narrowband-ultraviolet B phototherapy in the treatment of vitiligo: a pilot study. J Cosmet Dermatol. 2016;15(2):108-16.

Rashighi M, Harris JE. Vitiligo pathogenesis and emerging treatments. Dermatologic Clinics. 2017;35(2):257-65.

Salem SAM, Fezeaa TA, El Khazragy N, Soltan MY. Effect of platelet-rich plasma on the outcome of mini-punch grafting procedure in localized stable vitiligo: clinical evaluation and relation to lesional basic fibroblast growth factor. Dermatol Ther. 2021;34(2):e14738.

Parambath N, Sharma VK, Parihar AS, Sahni K, Gupta S. Use of platelet-rich plasma to suspend noncultured epidermal cell suspension improves repigmentation after autologous transplantation in stable vitiligo: a double-blind randomized controlled trial. Int J Dermatol. 2019;58(4):472-6.

Khattab FM, Abdelbary E, Fawzi M. Evaluation of combined excimer laser and platelet-rich plasma for the treatment of nonsegmental vitiligo: a prospective comparative study. J Cosmet Dermatol. 2020;19(4):869-77.

Chen J, Wan Y, Lin Y, Jiang H. Current art of combination therapy with autologous platelet-rich plasma for stable vitiligo: a meta-analysis. Int Wound J. 2021;18(3):251-60.

Shih S. Platelet-rich plasma: Potential role in combined therapy for vitiligo. Dermatol Ther. 2019;32(1):e12773.

Afify AA, Zuelfakkar NM, Eshafi MA. Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (a randomized clinical trial). Lasers Med Sci. 2021;36(7):1479-86.

Yin L, Adotama P, Svigos K, Gutierrez D, Sicco KL. Platelet-rich plasma, a promising adjunctive treatment for vitiligo: a case report. JAAD Case Rep. 2020;6(12):1320-2.

Esquivel D, Mishra R, Srivastava A. Stem cell therapy offers a possible safe and promising alternative approach for treating vitiligo: a review. Curr Pharm Des. 2020;26(37):4815-21.

Nagata MJH, Messora MR, Furlaneto FAC, et al. Effectiveness of two methods for preparation of autologous platelet-rich plasma: an experimental study in rabbits. Eur J Dent. 2010;4(4):395-402.

Carrillo-Mora P, González-Villalva A, Macías-Hernández SI, Villaseñor CP. Platelets-rich plasma: a versatile tool for regenerative medicine? Cir Cir. 2013;81(1):74-82.

Tun KM, Juntongjin P, editors. Efficacy of platelet-rich plasma in combination therapy for vitiligo. International Research Conference; 2020: Rangsit University.

Tawfik YM, Abd ELazim NE, Bakr RM, Abdel-Khalek LA, Gomaa AS. Management of acral vitiligo using Narrow band UVB, microneedling with and without platelet rich plasma. 2023. 10.21203/rs.3.rs-2648905/v1.

Kale MS, Chavan DD, Jamale VP, Nikam BP, Hussain A, Rai R, et al. To compare the safety & efficacy of platelet rich plasma therapy plus narrowband ultravoilet B (NBUVB) therapy versus narrowband ultravoilet B therapy alone in the treatment of vitiligo–a double blind, randomised controlled study. J Med Sci Clin Res. 2019;7(3):314-21.

Elsaadany AE, El‐Khalawany M, Elshahid AR, Seddeik Abdel‐Hameed AK. Comparison between 308‐nm excimer light alone versus 308‐nm excimer light and platelet‐rich plasma in the treatment for localized vitiligo. J Cosmet Dermatol. 2022;21(7):2826-31.

Abdelghani R, Ahmed NA, Darwish HM. Combined treatment with fractional carbon dioxide laser, autologous platelet‐rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: a prospective, randomized comparative trial. J Cosmet Dermatol. 2018;17(3):365-72.

Bashir F, Shaheen G, Tahir K, Amin U, Naveed A, Tahir M. Efficacy of fractional carbon dioxide laser and platelet rich plasma versus fractional carbon dioxide laser alone in patients of vitiligo. J Pak Assoc Dermatol. 2024;34(1):123-9.

Pandey AK, Mohan A, Satyaraj P. Comparative study of narrowband-ultraviolet B plus intralesional normal saline versus narrowband-ultraviolet B with platelet rich plasma in treatment of vitiligo. Int J Res Dermatol. 2023;9(4):175-81

Fawzy M, Al-Mokadem S, Alshereef M, Elkholy B. Narrowband ultraviolet B phototherapy combined with intralesional injection of either latanoprost or platelet-rich plasma for stable nonsegmental vitiligo. Photodermatol Photoimmunol Photomed. 2024;40(1):e12929.

doi: 10.1111/phpp.12929. Epub 2023 Nov 20. PMID: 37984828.

Mahajan R, Ninama K, Shah H, Bilimoria F. Effect of intralesional platelet rich plasma in chronic localized vitiligo. Int J Res Dermatol. 2018;4(4):550-5.

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Published

2024-12-31

How to Cite

1.
Shaukat S, Riaz T, Zahoor M, Afzal A, Gardezi SAA, Butt G, Hussain I. Comparison of effectiveness and safety of narrow band ultraviolet B with and without platelet rich plasma in the treatment of vitiligo. J Pak Assoc Dermatol [Internet]. 2024Dec.31 [cited 2025Feb.16];34(4 Suppl.):S64-S71. Available from: https://jpad.com.pk/index.php/jpad/article/view/3071

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