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Corresponding Author

Abdallah Mamdouh lotfy Ali

Document Type

Original Article

Abstract

Background: Vitiligo, an acquired disorder characterized by depigmentation, has an unidentified etiology. The pathogenesis of this condition has been the subject of various hypotheses, such as autoimmune, neurohumoral, and autocytotoxic theories.

Aim and objectives: To evaluate dermoscopically the efficacy of topical Trichloroacetic acid 70% versus methoxsalen 0.2 % paint in acral vitiligo, a comparative cross-sectional study.

Patients and methods: This comparative cross-sectional study evaluated dermoscopically the efficacy of topical Trichloroacetic acid (TCA) 70% versus methoxsalen 0.2 % paint in stable acral vitiligo. Response to the treatment was determined dermoscopically by marginal pigmentation appearance of the reticular network, marginal pigmentation, perifollicular pigmentation, and mixed re-pigmentation patterns. This study included 50 patients suffering from stable acral vitiligo divided into 2 equal groups: Group A (n=25) received topical methoxsalen 0.2 % every other day for 3 months, with a dermoscopic follow-up every 2 weeks. Group B (n=25) received topical TCA 70% application at the clinic every two weeks for 3 months with dermoscopic follow-up.

Results: All cases of non-re-pigmentation dermoscopically showed no clinical improvement. In contrast, one case showed marginal pigmentation and the appearance of a reticular network, and this case showed mild clinical improvement. Also, in two cases with mixed repigmentation, one showed moderate clinical improvement, and the other showed good clinical improvement.

Conclusion: TCA demonstrates a notably better response and higher patient satisfaction compared to methoxsalen. Consequently, TCA 70% emerges as a preferable recommendation for acral vitiligo treatment over methoxsalen. TCA 70% had a lower effective rate (6 cases only improved of a total of 25 cases).

Keywords

Dermoscopic evaluation; Topical Trichloroacetic acid 70%; Methoxsalen 0.2 %; Acral vitiligo

Subject Area

Dermatology

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