Mahmoud H. A. MONTASER, Hager Adel ZAKY, Almostafa Mohamed AHMED
Turkish Journal of Dermatology - 2026;20(3):101-109
Aim: This study aimed to investigate the efficacy of topical tyrosine versus tacrolimus as co-therapies in vitiligo patients undergoing narrowband ultraviolet B (NB-UVB) therapy. Materials and Methods: Three comparable vitiligo patches were selected from each patient (n = 67) and randomly assigned to tyrosine 2% plus NB-UVB (group I), tacrolimus 0.1% plus NB-UVB (group II), and NB-UVB alone (control). Topical treatments were applied twice daily, while NB-UVB phototherapy was administered twice weekly at the minimal erythema dose for three months. Results: Repigmentation differed significantly among the study groups (P < 0.001). The tacrolimus plus NB-UVB group showed the highest repigmentation [median (interquartile range): 60.0% (37.0-70.0)], followed by the tyrosine plus NB-UVB group [28.0% (16.0-46.0)], while the NB-UVB alone group demonstrated the lowest repigmentation [12% (10.0-21.0)]. Estimated effect size showed that pairwise comparisons between each active treatment group (groups I and II) and the control group for responder status (>= 25% repigmentation) were significant (McNemar's test, P < 0.001). Odds ratios were 5.5 (95% confidence interval: 2.3-13.1) for group I vs. control, and 89 for group II vs. control. Across all study groups, the stepwise linear regression model demonstrated that a shorter time since the last disease activity and a lower vitiligo area scoring index were the strongest predictors of a higher vitiligo extent score by target area. Conclusion: Combination therapy appears to be more effective for the management of vitiligo. Tacrolimus combined with NB-UVB achieved the highest repigmentation outcomes, whereas tyrosine combined with NB-UVB may represent a promising, safe, and potentially beneficial adjunct. Early initiation of the treatment may improve repigmentation, particularly in patients with limited disease severity.
