Comparative efficacy and safety of targeted narrowband ultraviolet B, 308-nm excimer laser, and 308-nm excimer lamp in vitiligo: a retrospective study

Background: Data directly comparing targeted narrowband ultraviolet B (NB-UVB), 308-nm excimer laser, and 308-nm excimer lamp for vitiligo are limited. Objectives: We compared the efficacy and safety of these three modalities in vitiligo. Methods: In this retrospective study, we reviewed the medical records of vitiligo patients at the Photodermatology Clinic, Siriraj Hospital. Patients received either targeted NB-UVB (group A), a 308-nm excimer laser (group B), or a 308-nm excimer lamp (group C), administered two to three times per week for at least 3 months. Photographs taken before and after therapy were evaluated. The primary outcome was repigmentation, graded on a five-tier scale: poor (0–25%), fair (26–50%), good (51–75%), very good (76–90%), and excellent (91–100%). The secondary outcome was treatment-related adverse events. Results: No statistically significant differences in efficacy were observed among the three groups, indicated by a very good to excellent response in 42.4% (group A), 17.6% (group B), and 29.4% (group C). Although group A showed higher response rates at 3 and 6 months, differences were not significant. Adverse effects were significantly more frequent in group C. Conclusions: All three devices demonstrated comparable efficacy and promoted rapid repigmentation. However, the excimer lamp had the highest rate of adverse effects.