The Value of Adding Mini-oral Pulse Steroid Therapy in Preventing Peri-lesional Halo Post Non-cultured Epidermal Cell Suspension (NCES) in Cases With Stable Segmental and Non-acral Vitiligo.

The Value of Adding Mini-oral Pulse Steroid Therapy in Preventing Peri-lesional Halo Post Non-cultured Epidermal Cell Suspension (NCES) in Cases With Stable Segmental and Non-acral Vitiligo: An Interventional Prospective Randomized Controlled Trial.

The goal of this clinical trial is to learn if adding mini-oral pulse steroid therapy improves the results of non-cultured epidermal cell suspension (NCES) surgery in patients with stable vitiligo. It will also evaluate the safety of this treatment approach. The main questions it aims to answer are:

• Does adding mini-oral pulse steroid therapy reduce the development of a perilesional halo after NCES surgery?
• Does the addition of steroids improve the degree of repigmentation and overall treatment outcomes in vitiligo lesions?

Researchers will compare NCES surgery with mini-oral pulse steroids to NCES surgery alone to determine whether the steroid therapy improves surgical outcomes.

Participants will:

• Undergo NCES vitiligo surgery for stable segmental or non-acral vitiligo lesions.
• Be randomly assigned to receive either surgery alone or surgery plus low-dose oral mini-pulse dexamethasone therapy.
• Attend follow-up visits and clinical assessments for approximately 4 months.
• Receive excimer laser sessions twice weekly after healing and have standardized photographs and scoring assessments to evaluate repigmentation.

Inclusion criteria:

• Patients with segmental vitiligo lesions that are not responsive to conventional treatment.
• Patients with non-Acral vitiligo lesions that are not responsive to conventional treatment and on sites known to be responsive to surgery, like the face and trunk.
• Stability for ≥ 1 year.
• Age ≥12 years.
• Lack of systemic and topical treatment for at least 3 months prior inclusion in the study.

Exclusion criteria:

• Acral vitiligo.
• Segmental vitiligo lesions that are responsive to conventional treatment.
• Non acral vitiligo lesions on sites that are knowingly not responsive to surgery, like knees and elbows.
• Active vitiligo; new lesions, expansion of old lesions, confetti like lesions, ill-defined edges, hypochromia, depigmentation of previously pigmented areas or koebnerization in < 1 year.
• Age < 12 years.
• Pregnant females.
• Patients with contraindication to systemic steroid like uncontrolled hypertension, diabetes or tuberculosis
• Systemic and topical treatment in the past 3 months.