Assessment of Dermatology Life Quality Index in Vitiligo Patients Treated with Narrow Band Ultraviolet B Therapy: A Prospective Interventional Study

Abstract

Introduction: Vitiligo is a disorder of skin pigmentation that is associated with tremendous psychological impact on the affected patients. The prevalence of vitiligo range from 0.1% to 8%. Narrow Band Ultraviolet B (NBUVB) therapy has been reported to be effective and a safe tool in vitiligo. Aim: To determine the effect of NBUVB treatment on vitiligo patients and to assess the impact on Dermatology Life Quality Index (DLQI) of patients after the therapy. Materials and Methods: This was a prospective study conducted pre and post intervention (NBUVB) on all the vitiligo patients attending Dermatology Outpatient Department (OPD) at our Institute from January 2019 to June 2019. The estimated sample size was 80 patients. The patients who met the inclusion criteria underwent whole body NBUVB irradiation. The treatment was started with an initial dose of 300 mJ/cm2 in all the cases. It was administered two days per week on non consecutive days. The irradiation dose was increased by 50 mJ/cm2 on each subsequent visit until the optimal dose was obtained to have a minimal erythema in the lesion. The DLQI questionnaire designed by Finlay and Khan was used to determine the quality of life impairment in the study patients. The DLQI scoring was done twice, the first scoring at the start of therapy and the second scoring at the end of therapy. The data was analysed using Statistical Package for the Social Sciences (SPSS) 20.0 version software for determining statistical significance. Chi-square test, Fisher-exact test and odds ratio were used to check for the associated factors, p-value <0.05 was considered to be statistically significant. Results: A total of 79 patients were included in the study. Age ranged from 18 to 72 years, with a mean age of 43.2±15.14 years. The sex distribution among study patients was almost equal, with 39 females and 40 males. The duration of NBUVB irradiation ranged from two months to six months. The cumulative number of NBUVB irradiation sessions ranged from 14 to 48, with an average of 22.65±7.42 sessions. The grade of repigmentation in the study group was excellent in 2 (2.5%), good in 52 (65.8%), average in 25 (31.7%) and poor in none. The baseline DLQI score distribution ranged from 6 to 28, with mean score of 11.76±3.69. The end of therapy DLQI score ranged from 0-7, with mean score of 2.58±2.32. The difference between the mean baseline DLQI score and end of therapy DLQI score was statistically significant. Conclusion: The NBUVB treatment is effective on vitiligo patients in achieving repigmentation of depigmented patches. The baseline DLQI score of vitiligo patients were high, and it significantly decreased after the NBUVB therapy.