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Government Medical College, India
Posters & Accepted Abstracts: J Clin Exp Dermatol Res
Background: Achromic fissures and perigraft halo are well known complication of split thickness skin grafting in stable vitiligo. PUVA and PUVA-sol are established therapies for these unwanted side effects but no comparative study till now has been done for topical steroid in the treatment of perigraft hallow. Objectives: The aim of this study was to evaluate the efficacy of topical corticosteroid in perigraft hallow and achromic fissures and to compare it with perigraft pigmentation after PUVA in patients with stable vitiligo. Methods: 50 patients with stable vitiligo of various clinical variants were subjected to split thickness skin grafting. They were randomized into two groups: One group received post grafting PUVA (group I) and the other group post grafting topical application of fluticasone propionate cream, 0.05% (group II). During the next 6 months follow-up, 4 patients were lost to follow-up and two patients were excluded from the study; 40 patients were evaluated for pigment spread and side effects. Results: In group I, the average pigment spread was 7.44 mm, whereas in group II, it was 7.94 mm, showing a slightly higher pigment spread in group II, which was statistically not significant. 19 cases (76%) of group I compare to 21 cases (84%) of group II showed >90% pigmentation on vitiligo area severity index. There was no difference in response to therapy in patients having segmental vitiligo as compared with non-segmental vitiligo. Infection, milia, hypertrophy of graft, hyperpigmentation and hypopigmentation of graft were few side effects seen in some patients in both groups. Conclusion: The study shows that the pigment spread with topical corticosteroid is comparable to that with PUVA. However, longterm follow-up are required to establish this. The advantages of topical corticosteroid are that its use is easy, less cumbersome, cheaper and more cost effective than PUVA.