Topical tacalcitol and 308-nm monochromatic excimer light: a synergistic combination for the treatment of vitiligo

Background/purpose: To study and compare the efficacy of combined 308-nm monochromatic excimer light (MEL) therapy with tacalcitol vs. that of MEL 308-nm therapy alone in treatment of vitiligo. Methods: Thirty-eight patients with vitiligo were enrolled in a single-blind, within patient controlled clinical trial. Symmetrical or nearby lesions were randomly applied with either topical tacalcitol cream or vehicle. Each lesion was treated weekly with the 308-nm MEL, for a total of 12 sessions. Patients were examined at monthly intervals. The mean number of sessions and the cumulative dosage for initial repigmentation were calculated. Result: Thirty-five patients were evaluated. Treatment with tacalcitol and MEL resulted in higher percentages for excellent repigmentation (25.7%) compared with vehicle and MEL (5.7%) (P < 0.05). Percentages for total response were 71.4% and 60%, respectively (P > 0.05). The mean +/- SEM cumulative dose and number of excimer light exposures for initial repigmentation were, respectively, 3.93 +/- 0.59 J/cm(2) and 4.52 +/- 0.49 at the tacalcitol side, and, respectively, 4.99 +/- 0.68 J/cm(2) and 5.3 +/- 0.52 at the vehicle side (P < 0.05). Conclusion: Our results have shown that concurrent topical tacalcitol potentiates the efficacy of the 308-nm MEL in the treatment of vitiligo, and that this combination achieves earlier pigmentation with a lower total dosage.