A Comparative Study on the Efficacy and Safety of Using Azathioprine Alone, Combining It with Narrow Band (UVB) and to Oral Minipulse Steroids Plus NB-UVB in Stabilizing Active Non-Segmental Vitiligo

Vitiligo is an acquired, non-contagious, pigmentary disease resulting from the loss of melanocytes from skin, hair and mucous membranes. The pathogenesis of vitiligo is still not fully understood and mounting evidences have suggested that it might be related to autoimmunity and oxidative stress.

To evaluate the efficacy and safety of AZA in stabilizing disease progression of active vitiligo, compare it with its combined therapy with NB-UVB and with OMP steroids combined with NB-UVB.

This study included Forty five patients complaining of active non-segmental vitiligo divided into three groups: Group (A): 15 patients received narrow band therapy with oral mini-pulse steroid therapy (dexamethasone) as a single dose on two consecutive days repeated every week for 3 months, Group (B): 15 patients received narrow band therapy (same regimen as in group A) combined with oral azathioprine 50 mg twice daily for 3 months, and group (C): 15 patients received oral azathioprine alone for 3 months.

Evaluation of treatment response was done at 4, 8 and 12 weeks of treatment by assessing the onset of stoppage of disease activity as well as the onset of repigmentation and its extent using VES, VES plus and VIDA scores. Encountered side effects were also documented.

Both oral minipulse steroid therapy and azathioprine are effective in stopping the activity of vitiligo, either as monotherapy or better combininig with NBUVB, though azathioprine being inferior to OMP steroid therapy in arresting disease progression and inducing re-pigmentation. Thus, it can be used as a good alternative when there is contraindication to use systemic steroids.