Efficacy and safety of tretinoin 0.05% cream to prevent hyperpigmentation during narrowband UV-B phototherapy in patients with facial vitiligo: a randomized clinical trial

Abstract

Background

Narrowband UV-B (NBUVB) phototherapy is the mainstay of vitiligo treatment, but hyperpigmentation is one of the limitations. Meanwhile, topical tretinoin is effective against pigmentary disorders.

Objective

To determine whether tretinoin 0.05% cream would prevent hyperpigmentation when patients with facial vitiligo underwent phototherapy.

Methods

A randomized, controlled, split-face trial was conducted. Adult patients with stable, non-segmental facial vitiligo were enrolled. The left/right sides of the face were randomly allocated to receive either topical tretinoin 0.05% cream or moisturizer twice daily. The entire face was subjected to NBUVB phototherapy twice weekly for 12 weeks. The degree of hyperpigmentation was assessed as the delta L* (brightness) value of the darkest spot in each side of the face at baseline and every 4 weeks. The degree of repigmentation was assessed.

Results

Twenty-five patients were enrolled; 21 completed the study. The delta L* value was significantly different between the two groups: −0.5% in the tretinoin group and −8.7% in the control group at 12 weeks (p = .002). Marked repigmentation was achieved in 15 patients of both groups.

Conclusions

Tretinoin 0.05% cream prevented hyperpigmentation during NBUVB phototherapy in patients with facial vitiligo, and did not compromise the overall treatment response.

Trial registration

ClinicalTrials.gov NCT03933774

Keywords:

• Narrowband UVB
• perilesional hyperpigmentation
• photoadaptation
• retinoid
• side effect

Acknowledgments

The patients in this manuscript have given written informed consent to publication of their case details. The authors would like to thank all patients in this study.

Author contributions

All authors had full access to all data and accept responsibility for the integrity and accuracy of the data analysis. Study concept and design: Drs. Bae and Lee. Acquisition, analysis, and interpretation of the data: Drs. Bae and Ju. Drafting of the manuscript: Drs. Bae and Ju. Critical revision of the manuscript in terms of important intellectual content: Dr. Kim. Statistical analysis: Dr. Ju. Administrative, technical, or material support: Drs. Lee and Kim. Study supervision: Drs. Bae and Kim.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding for this study was provided by GlaxoSmithKline (study ID 208853).