الفهرس 
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Abstract
S
UMMARY
itiligo is a depigmented disease of the skin with unknown etiology. Different treatment modalities were considered in treatment of vitiligo but without sufficient satisfactory outcome. Acral vitiligo is very resistant to the known lines of treatment. In the current study, we aimed to evaluate the effect of tPUVA in the treatment of acral vitiligo and to correlate the response to treatment with different types of new classification of hand vitiligo, correlate with VIDA and VESTA score and report the side effects of tPUVA. We included 31 patients presented with acral vitiligo. The patients hands were divided randomly to two groups according to treatment used as follow;
1) Topical Puva
2) Topical placebo+UVA
Patients received two sessions of phototherapy weekly on non-consecutive days with a minimum of 25 sessions over a period of 16 weeks. Patients started with NB-UVB to the whole body (starting with 00.30 J/cm2 and increasing each time by 20% till faint erythema occurs), followed on the same day by tPUVA on one hand and vehicle without methoxsalen on the other hand (placebo) choosen randomly.
Both hands were assessed before and after treatment using Digital photography, measurement of surface area of vitiligo lesions using VESTA score and VACAG score.
V
Summary
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Patients, satisfaction was performed after end of treatment protocol for every therapeutic modality.
Assessment of patients, response to treatment revealed no statistically significant improvement in both treatment groups.
Assessment of repigmentation using VESTA score before and after treatment with each treatment modality revealed highest repigmentation scores with active treatment group in comparison to placebo group.
On comparison the percentage of repigmentation among placebo and active treatment group there was no statistical significance.
Regarding safety of considered therapy, Erythema, pain, skin burn, hyperpigmentation and edema was reported with active treatment (tPUVA)