الفهرس 
VITILIGOOnly 14 pages are availabe for public view
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Abstract
V
itiligo is an acquired chronic disorder of the skin, characterized by the appearance of well circumscribed milky depigmented macules or patches. It occurs worldwide in about 0.5 and 2% of different population and it occurs in all people with no predilection in gender, race, or skin type. It is a multifactorial polygenic disorder with a complex pathogenesis, linked with both genetic and non-genetic factors working in concert.
Many methods are available for evaluation of vitiligo severity, one of methods is Vitiligo extent tensity index (VETI) that is used in our study.
There are many treatment options, Narrow band UVB is consider more safe and effective but the optimal treatment has not yet been identified.
In the present study, we aimed to evaluate the efficacy and safety of topical psoralen-narrow band ultraviolet B for the treatment of non-segmental vitiligo in comparison to narrow band ultraviolet B alone. It represents prospective intervension study which was carried out on 40 patients diagnosed as non segmental vitiligo in two groups (20 patients in each), 32 patients with active vitiligo, 8 patients with stable vitiligo.
All patients were subjected to 48th NB-UVB sessions (3 sessions /week), twenty of them was applied topical 8-methoxypsoralen 30 minutes before photo session. In all patients one patch of vitiliginous skin lesion was treated by topical psoralen only without exposure to NB-UVB.
In the current study, there was a significant higher values of stress affected patient in group II versus group I. While non significant differences between group I versus group II as regards regards age, sex, smoker, family history, activity of disease, associated diseases and duration of disease.
The comparison between VETI score before treatment and after treatment in each group revealed that the difference was statistically highly significant (p<0.05).
The comparison between the group I (treated with NB-UVB alone) versus group II (treated with topical psoralen plus NB-UVB) as regards VETI score before and after treatment revealed that the difference was statistically non significant (p>0.05).
The comparison between the active disease in group I versus active disease in group II as regards VETI score before and after treatment revealed that the difference was statistically non significant (p>0.05).
The comparison between the stable disease in group I versus stable disease in group II as regards VETI score before and after treatment revealed that the difference was statistically non significant (p>0.05).
The relation of VETI score before treatment with the other studied parameters in group II revealed that was statistically significant relation between VETI score before treatment and factor worsening disease (stress) (p<0.01), as well as stastically significant between the active disease in group I and active disease in group II regarding factor worsening disease (stress) (p<0.05). But the difference between the stable disease in group I and stable disease in group II was statistically non significant (p>0.05).
There was no effect of topical psoralen alone on covered patch revealed that psoralen it is only act when it sensitized by ultraviolet rays.
Finally, on the basis of the results in both groups of studies, we conclude that topical psoralen plus narrow band UVB is an effective and safe, well tolerated line of management for non segmental vitiligo. It efficacy is equal to, but not superior to narrow band UVB alone.