Comparative study of Microneedling with Topical 5- Fluorouracil 5 percent cream versus Topical Clobetasol propionate 0.05% in stable vitiligo

Vitiligo is an acquired primary disorder of pigmentation of unknown etiology, characterized clinically by depigmented macules and patches. Stability in vitiligo is defined as the absence of new lesions, no progression of existing lesions, and no occurrence of the Koebner phenomenon over the past year. Current treatment options include topical and systemic medications, phototherapy, laser therapy, and surgical interventions. Combined treatments, which integrate conventional and newer therapeutic methods, have shown superior efficacy, faster response, and better safety profiles compared to monotherapies. Microneedling is employed as a transdermal drug delivery technique to enhance the absorption of topical immunomodulators. The application of a microneedling device creates microchannels or pores in the stratum corneum, facilitating better drug penetration. This technique helps improve drug efficacy and may reduce the duration of treatment. 5-Fluorouracil (5-FU), an antimitotic agent known to stimulate melanocyte migration and proliferation, is being investigated for topical and intradermal use in the treatment of vitiligo. Topical corticosteroids are considered the first-line treatment for vitiligo. They are typically applied once or twice daily over the entire affected lesion and are especially useful in early or localized disease. The primary outcome of the study includes the clinical repigmentation, evaluated using G-score to compare the efficacy of such combined medical and surgical modalities with the standard treatment of vitiligo, that is, topical potent corticosteroid. Hence, this will help in comparing and finding out a better treatment option for providing safe, effective and easily reproducible option for stable vitiligo, while taking into consideration the side effects, if any, observed in the study.