A comparative study of the efficacy of potent topical corticosteroids per se versus combination of potent topical corticosteroids with fractional CO2 laser in the management of vitiligo vulgaris.

Abstract

Objectives: The study aimed to compare the efficacy of two treatment modalities in vitiligo vulgaris that is - potent topical corticosteroid (betamethasone-dipropionate lotion 0.05%) with FrCO₂ laser versus Potent topical corticosteroid (PTS) alone, and to observe side effects if any.

Material and methods: Sixty cases with stable vitiligo (vitiligo vulgaris including focal vitiligo) >12 years of age with <27% body surface area were included in the study. The Institutional Ethics Committee approval was taken. After taking consent and clinical photographs, cases were randomly allocated into two groups of 30 patients each: Group A received FrCO₂ laser (power-6W, random mode) once a month + twice daily application of PTS (betamethasone dipropionate lotion 0.05%) over patches and Group B applied PTS only twice daily (betamethasone dipropionate lotion 0.05%). The response was assessed at the end of 3 months.

Results: The mean vitiligo area scoring index (VASI) score at baseline for Group A was 1.17 ± 0.59, and after 3 months was 0.60 ± 0.56. For Group B, the mean VASI at baseline was 0.87 ± 0.35 and after 3 months was 0.63 ± 0.50. The p value of group B was 0.003 and for group A was 0.001. Even though the reduction in mean VASI was statistically significant in both groups, Group A showed a better response. Group A showed good to excellent response in 16.67% while Group B only cases in 3.3%. This suggests that the addition of FrCO₂ to steroids may provide superior repigmentation.

Conclusion: The addition of FrCO₂ laser to topical corticosteroids offers a safe and promising approach and can be considered in patients who are unresponsive to other treatment modalities.