Segmental vitiligo is a distinct clinical subtype that follows a unilateral, dermatomal distribution. It tends to progress rapidly during its active phase, making the timing of treatment a central clinical decision.
This protocol addresses patients with segmental vitiligo in its early, active stage. Early intervention is especially critical here because repigmentation becomes notoriously difficult in later stages — the window for an effective response is narrow.
Early management prioritises prompt initiation of phototherapy — narrow-band UVB or, for more localised lesions, targeted laser-based approaches — in combination with topical and systemic agents. This structured combination approach is designed to halt active disease spread and promote repigmentation. The full regimen, agent selection, and sequencing are available in the complete protocol.
Halt of disease activity and repigmentation of the lesions.
DOI: 10.1111/jdv.19450
Early initiation of NB-UVB is encouraged, because of its ability to halt disease activity and induce repigmentation.
This is especially important in segmental and acral vitiligo, where repigmentation is notoriously difficult in later stages.
The use of systemic steroids (prednisolone 20 mg/day or 0.3 mg per kg body weight/day in children) for 3 weeks in combination with excimer laser and TCI has also been reported to be beneficial in early SV.
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