Effect of Topical 5% 5-Fluorouracil with Microneedling in Vitiligo Patients as an Additional Modality to Standard Treatment at Tertiary Care Hospital.

Background: Vitiligo is an inveterate disease of great aesthetic concern presenting with depigmented macules and patches. It is often incorrigible to medical treatment.

Aim: To study the clinical profile of vitiligo patients and evaluate the effect of 5% 5-fluorouracil (5-FU) cream with microneedling.

Materials and methods: This observational analytical study was conducted from November 2019 to July 2021. A total of 33 adult vitiligo patients were treated with oral mini-pulse (dexamethasone) therapy and topical corticosteroid (clobetasol propionate 0.05%). Patient's total number of vitiligo lesions with <10-cm size were counted and half of the lesions were treated with 5-FU + microneedling (Group A), while a remaining number of lesions were not treated with 5-FU + microneedling (Group B). In the case of the odd number of lesions, the total number of lesions minus one was considered and then divided into equal numbers for treatment. The procedure was performed every 2 weeks for 3 months. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading scores.

Results: Initiation of repigmentation started in the first month in Group A, whereas in Group B, it was seen in the second, which was statistically significant (P < 0.0001). Excellent improvement (>75% repigmentation) was noted in Group A as compared to Group B at the end of 6 months (P < 0.0001).

Conclusions: Needling with 5% 5-FU appears to be a simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.