Microneedling plus tacrolimus versus tacrolimus alone in conjunction with narrow band UVB in the treatment of vitiligo; A randomised control trial.

Objective: To compare the efficacy of microneedling plus Tacrolimus with narrow band UVB versus tacrolimus with narrow band UVB in the treatment of vitiligo. Study Design: Randomized Controlled Trial. Setting: Department of Dermatology, Madinah Teaching Hospital, Faisalabad. Period: 05-06-2023 to 5-12-23. Methods: Enrolled 28 patients with stable Vitiligo for the last 3 months, aged 15 to 60 years. Patients were assigned to group A and B, treated with microneedling plus topical tacrolimus 0.1% with narrow band UVB and tacrolimus ointment twice a day. The study focused on evaluating the repigmentation response during subsequent follow-up visits, using a comprehensive four-grade scale. The results were analyzed using SPSS 26. Results: The study involved 34 patients with face lesions. Six patients lost follow-up and were excluded. The study included 16 males and 12 females, with a mean age of 29.4 + 11 years. After the treatment, the first follow-up visit showed significant improvement in 17 of 28 patients (60.7%) in group A (microneedling pus Tacrolimus with narrow band UVB) compared to 32.1% in group B (Tacrolimus with narrow band UVB). The efficacy was categorized into five levels: 'excellent' in 25% cases in group A and 21.4% in group B, and very good' in 35.7 vs 10.7%. At 12 weeks, overall efficacy was seen in 71.4% in group A and 39.3% in group B. The study's findings suggest that microneedling plus tacrolimus with narrow band UVB may be a more effective treatment for vitiligo. Conclusion: Microneedling, a technique using delicate needles to puncture the dermis, has been shown to promote collagen synthesis and enhance the absorption of tacrolimus, a drug used for immunosuppression, potentially aiding in vitiligo repigmentation, but further localized studies are needed.