Evaluation of the additive effect of peeling with 15% TCA on the response to phototherapy in patients with acral vitiligo referred to dermatology clinics of Mashhad University of Medical Sciences, Iran

Background; Vitiligo is a chronic skin disease with pigmentation disorder resulting in excessive psychological stress for patients with discolored spots. Despite methods including phototherapy, local and systemic immunosuppressants, and surgical techniques, the treatment of vitiligo is still one of the most difficult dermatology challenges. This study aimed to evaluate the additive effect of peeling with 15% TCA trichloroacetic acid solution on the response to phototherapy in patients with acral vitiligo. Methods; Patients with vitiligo referred to Imam Reza Hospital in Mashhad were examined for the extent of organ involvement by the disease using photography. Phototherapy was performed as a standard treatment and one limb was treated with chemical peeling with 15% TCA for 4 sessions once a week before receiving phototherapy. Then, the rate of repigmentation of the patient's limbs after treatment with phototherapy along with chemical peeling was measured with 15% TCA and compared with the side that received only phototherapy treatment. Results; 40 patients with acral vitiligo were studied, 55% of whom were female. Data regarding the percentage of healing of skin lesions in the intervention and control groups were evaluated by specialists. According to the results, the highest number of lesions, 37 from the control group and 26 from the intervention group, had a recovery percentage of less than 25%, followed by 6 lesions from the intervention group with an improvement of 25 to 50%. Assessing the therapeutic effect using the final score the mean score was 1.6 in the intervention, and 1 in the control group. The final scores of the intervention and control groups were compared using paired t-tests and a significant difference was found. Conclusions; The results of this study support the effectiveness of TCA in causing repigmentation in acral vitiligo patches.