International Journal of Medical Advances and Discoveries

International Scholars Journal of Medical Advances and Discoveries | Vol. 16, No. 4, April 2025 | pp. 17–24

DOI: 10.46882/2025/IJMAD/000103

Original Research Article

Title: Comparative Efficacy of Topical Tacrolimus versus Narrowband Ultraviolet B Phototherapy in Refractory Vitiligo

Names of Authors: K. L. Rossi¹, M. N. Al-Mansoor²

Authors’ Affiliations: ¹Department of Dermatology, Mediterranean Medical Institute, Rome, Italy; ²Department of Dermatology and Venereology, King Saud University, Riyadh, Saudi Arabia

Abstract: Vitiligo is an acquired depigmenting dermatosis that profoundly impacts patient quality of life. This randomized comparative trial evaluated the relative therapeutic efficacy and safety profile of topical tacrolimus 0.1% ointment versus narrowband ultraviolet B (NBUVB) phototherapy administered twice weekly over a 24-week intervention window. A cohort of 150 patients with symmetrical, non-segmental vitiligo involving 10% to 30% of the total body surface area was assigned to two parallel treatment arms. Repigmentation was quantified using the Vitiligo Area Scoring Index (VASI) alongside digital computerized image analysis. At week 24, the NBUVB cohort achieved a mean VASI reduction of 58.2 ± 12.4%, compared to 42.1 ± 15.6% in the topical tacrolimus group (P = 0.002). However, facial lesions exhibited comparable repigmentation velocities across both modalities (exceeding 70% response). Combination therapy analysis in a pilot subgroup suggested synergistic enhancement when tacrolimus was applied on localized recalcitrant acral areas undergoing NBUVB sessions. Adverse events were generally mild and self-limiting; transient burning sensation was reported by 22% of tacrolimus users, whereas mild erythema and xerosis occurred in 31% of the NBUVB group. No severe phototoxic reactions or systemic malignancies were documented during the follow-up period. The data indicate that while NBUVB remains superior for generalized truncal involvement, topical tacrolimus serves as an exceptional site-specific alternative or adjunct, particularly for sensitive anatomical zones where cumulative UV exposure must be strictly controlled.

Keywords: Vitiligo; Tacrolimus; Narrowband UVB; Phototherapy; Repigmentation

Manuscript Timeline: Received: 05 December 2024; Revised: 12 March 2025; Accepted: 28 March 2025; Published: 05 April 2025

Citation: Rossi, K. L., & Al-Mansoor, M. N. (2025). Comparative Efficacy of Topical Tacrolimus versus Narrowband Ultraviolet B Phototherapy in Refractory Vitiligo. International Journal of Medical Advances and Discoveries, 16(4), 17–24.

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