Platelet-rich plasma versus microneedling effects in NB-UVB non-responder vitiligo patients

Background Narrow-band ultraviolet B (NB-UVB) is a crucial and effective line of treatment for nonsegmental vitiligo. Objective To compare the effect of adding platelet-rich plasma (PRP) injections versus microneedling sessions on the response to NB-UVB in patients who stopped giving response or did not give response from the start. Patients and methods An intrapatient randomized comparative study including 30 patients with stable, nonsegmental vitiligo was performed. Three lesions were assessed in each participant and randomly allocated to undergo PRP injections or microneedling every 2 weeks for four sessions. The third lesion was left as a control. Throughout the study, all lesions were subjected to NB-UVB three times a week. Photographic assessment by an independent dermatologist and a patient satisfaction questionnaire were used to assess repigmentation. Results PRP injection showed better results than microneedling in terms of repigmentation, complications, and patient satisfaction. The mean percentages of repigmentation in PRP, microneedling-treated, and control lesions were 58.17±21.52, 24.5±18.77, and 15.17±13.49, respectively ( P <0.001). The onset of repigmentation was earlier in the PRP-injected lesions compared with microneedling (3.97±1.607 and 7.8±2.683 weeks, respectively; P <0.001). Follicular repigmentation was the predominant pattern in PRP sites (50%). Conclusion PRP therapy is a secure and effective procedure that helps patients with vitiligo and speeds up their reaction to NB-UVB as well as supports and encourages their recall response.