title: Response to narrow-band UVB--vitiligo-melasma versus vitiligo: a comparative study.
abstract: BACKGROUND
  Vitiligo is the most common depigmentary disorder of the skin and hair, resulting from selective destruction of melanocytes. Melasma, a hyperpigmentary disorder, presents as irregular, brown, macular hypermelanosis. A small subset of vitiligo patients paradoxically also have melasma.
  
  
  OBJECTIVE
  To evaluate and compare the response to narrow-band UVB in a group of patients with vitiligo, and another group of patients with vitiligo and coexisting melasma (vitiligo-melasma).
  
  
  METHODS
  Patients in both groups were treated with narrow-band UVB and a comparison of the zonal repigmentation was made at 4, 8, and 12 weeks after the initiation of therapy.
  
  
  RESULTS
  At the end of 12 weeks, 86% of patients in the vitiligo-melasma group attained ≥75% pigmentation on the face, whereas this was achieved in only 12.5% of patients in the vitiligo group. Over the limbs, 73% of patients in the vitiligo-melasma group attained 75% or more pigmentation at the end of 12 weeks compared with only 9% in the vitiligo group. On the trunk, only 20% of vitiligo-melasma patients showed ≥75% pigmentation at 12 weeks compared with 63% of patients in the vitiligo group.
  
  
  CONCLUSIONS
  Patients having both vitiligo and melasma have a significantly better prognosis for repigmentation on the face and limbs with narrow-band UVB compared with patients with vitiligo alone; the vitiligo-melasma patients achieve repigmentation much earlier and also attain a greater level of repigmentation. Unexpectedly, for truncal lesions, patients with vitiligo alone responded better than those with both conditions. Although the vitiligo-melasma group with truncal lesions started repigmenting earlier, the final pigmentation was more extensive in the vitiligo group.
authors.affiliation: Department of Dermatology, Kasturba Medical College, Mangalore, India. drparikshit_sharma@yahoo.com
authors.forename: Parikshit
authors.initials: P
authors.lastname: Sharma
authors.forename: Harsha S
authors.initials: HS
authors.lastname: Pai
authors.forename: Ganesh S
authors.initials: GS
authors.lastname: Pai
authors.forename: Maria
authors.initials: M
authors.lastname: Kuruvila
authors.forename: Reshma
authors.initials: R
authors.lastname: Kolar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005121:Extremities; D005145:Face; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008548:Melanosis / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D011379:Prognosis; D012880:Skin Pigmentation; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*; D014820:Vitiligo / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult