Intralesional Therapy of Vitiligo by 1% Lactic Acid Solution Versus Triamcinolone Acetonide Injection

Vitiligo is a common autoimmune disease, where many topical and systemic therapies has been used, and each has its own advantages and disadvantages. Lactic acid has been used successfully in the treatment of vitiligo as a topical solution and was an effective intralesional therapy of alopecia areata. The objectives is to use 1% intralesional lactic acid in the treatment of vitiligo especially in localized patches. This is an interventional, case control, single blind, comparative study that was conducted in the Department of Dermatology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq, between April 2016 and July 2017. Forty-five patients with vitiligo and 64 patches were enrolled in this study, 33 (73.33%) patients were females and 12 (26%) patients were males, with a female to male ratio of 2.7:1. They were divided into 2 groups according to type of therapy. Group (A) (lactic acid 1% solution): twenty-three patients with 31 patches were included in this group. Lactic acid solution 1% was injected intralesionally every 2 weeks. Group (B) (triamcinolone acetonide injectable suspension): Twenty-two patients with 33 patches were included in this group. Intralesional triamcinolone acetonide was injected every 2 weeks. Treatment of both groups continued for 6 weeks (three sessions), and further three months as follow up. Group (A): The mean surface area of the lesions was decreased from 1.96 cm² to 1.10 cm² from the baseline visit to the last follow-up visit with a reduction rate mean of 33.9 and a P value of 0.00902, which was highly statistically significant. Group (B): The mean surface area of the lesions was decreased from 4.56 cm² to 3.93 cm² from the baseline visit to the last follow-up visit with a reduction rate mean of 20.9 and a P value of 0.93 and was statistically insignificant. In conclusion, lactic acid was proved statistically significant cost effective intralesional therapy for localized patches of vitiligo with a P value of 0.00902, while the use of triamcinolone acetonide intralesional injections gave a p value of 0.93 and was statistically insignificant