Surrounding Needling and Narrowband Ultraviolet B Phototherapy Treatment: Synergistic Effects for Repigmentation in Chronic, Stable Nonsegmental Vitiligo

Context • Narrowband ultraviolet B (NBUVB) phototherapy is the standard treatment for chronic stable vitiligo, but its efficacy, when used alone, is often unsatisfactory. Objective • The study evaluated the efficacy of surrounding needling with acupuncture needles in combination with NBUVB phototherapy for lesions on different body parts of patients with chronic stable vitiligo. Design • The research team designed a 12-week, randomized, open-label, prospective, intra-individual, comparative clinical trial. Setting • The study took place in the Department of Dermatology at Shin-Kong Wu Ho-Su Memorial Hospital in Taiwan. Participants • Participants were patients at the hospital, aged 20-80 years, with chronic stable nonsegmental vitiligo. The lesions on both sides of their bodies had the same baseline conditions. Nine patients with 14 pairs of lesions (n = 28) were included in the study, and eight participants with 13 pairs of lesions (n = 26) successfully completed the study. Intervention • Vitiligo lesions in the intervention group were treated with surrounding needling combined with NBUVB phototherapy, whereas the control group received NBUVB phototherapy only. Outcome Measures • The primary outcome was evaluated at Week 12 using the modified Vitiligo Area Scoring Index (VASI), which focuses on local depigmentation only without multiplication by body surface area, and the testing used the Wilcoxon signed-rank test. A higher VASI score indicates more severe vitiligo. Pain was rated postintervention, after completion of all treatments. Results • At baseline, the modified VASI score in both groups was 93.07 ± 4.62. Postintervention, this score in the intervention group improved to 78.46 ± 15.24, with a significant difference between baseline and postintervention (P = .007), and in the control group, the score improved to 91.92 ± 6.67, with no significant difference having occurred (P = .317). A statistically significant difference was found between the intervention group and the control group in the change in scores postintervention (P = .007). Conclusion • Surrounding needling in combination with NBUVB phototherapy may be a promising treatment for chronic stable nonsegmental vitiligo. Future studies with larger sample sizes and long-term follow-up are warranted.