A single blind active controlled study to compare the efficacy of microneedling and microneedling with 5-flurouracil in treatment of stable vitiligo

Introduction
Microneedling, a tool for transdermal delivery of drugs, improves the skin permeability to various therapeutic agents. 5-fluorouracil is a chemotherapeutic agent, a pyrimidine analogue, used in various combination chemotherapy regimens. It has been noticed that following topical 5-fluorouracil cream application, patients developed localized hyperpigmentation and this has gained the attention towards use of 5-fluorouracil in repigmentation of vitiliginous patches.

Objective
To assess the effectiveness of topical 5-fluorouracil following microneedling and to compare its results with microneedling alone in patients with stable vitiligo.

Material and methods
Forty patients with localized stable vitiligo were randomly divided into 2 groups of 20 each. In group A, patients were treated with microneedling alone and in group B, microneedling was followed by 5-flurouracil cream application every two weeks for 2 months and patients were followed up for 4 months after the last session. Repigmentation was assessed by grades ranging from grade 0 (G0) as no response to G4 as excellent response with > 75% repigmentation and any side effects were noted.

Results
Microneedling followed by 5-fluorouracil application showed better response than needling alone with minimal side effects and the results were statistically significant.

Conclusions
Microneedling with 5-fluorouracil yields positive therapeutic results in localized stable vitiligo.