The research on the treatment of stable acral vitiligo has received renewed focus with the exploration of topical therapies, particularly the comparative analysis of trichloroacetic acid (TCA) 70% and methoxsalen 0.2%. These modalities aim to address the challenges posed by this often-recalcitrant skin condition.
Vitiligo is characterized by the loss of melanocytes, resulting in distinctly depigmented patches on the skin, with stable acral vitiligo presenting significant therapeutic hurdles. Recent research conducted at Al Azhar University sought to evaluate the effectiveness of these two treatments through both clinical and dermatoscopic assessments.
The study enrolled 70 patients, dividing them evenly between the two treatment groups. One group applied methoxsalen every other day for four months, whereas the other received TCA treatment bi-weekly at the clinic over the same period.
At the trial's conclusion, findings revealed minimal progression, with the TCA group exhibiting an average improvement of 4.0%, and the methoxsalen group showing just 0.57% improvement. The majority of subjects reported either no change or merely mild improvement, demonstrating the limited effectiveness of both modalities.
Patient satisfaction was significantly low across both groups, with 82.9% of TCA subjects expressing dissatisfaction alongside most methoxsalen patients reporting no contentment with their treatment outcomes. This dissatisfaction reflects the struggles inherent to managing vitiligo, particularly at acral sites with decreased melanocyte density due to their anatomical characteristics.
The clinical data suggest not only the challenging nature of treating acral vitiligo but also hint at the need for more effective therapy protocols. Both treatments underperformed relative to prior studies, calling for multi-centered research utilizing diverse concentrations and combinations of therapies. Results evidently indicate insufficient repigmentation with the current methods, emphasizing the necessity for alternative strategies.
Overall, this examination sheds light on the nuanced challenges faced by both physicians and patients combating vitiligo. It showcases the persistent need strides toward more efficacious therapeutic solutions for this chronic skin condition.