The use of trichloroacetic acid as a depigmenting therapy in universal vitiligo.

Background And Objectives: Several modalities have been used to clear residual facial pigmentation in patients with extensive vitiligo; however, the ideal depigmenting agent does not yet exist. The use of trichloroacetic acid (TCA) for depigmentation in universal vitiligo has been recently reported. We aim to evaluate the efficacy and safety of TCA 100 % as a depigmenting therapy for recalcitrant facial pigmentation in Egyptian patients with universal vitiligo.

Patients And Methods: The study included 50 patients with universal vitiligo who had residual spotted pigmentation on the face causing psychological distress. TCA was focally applied to cover the pigmented patches at 100 % concentration. The treatment was repeated every two weeks until complete depigmentation or for a maximum of five treatment sessions.

Results: Excellent response to TCA treatment (> 90 % depigmentation) was reported in 80 % of the studied cases, partial response (50-90 % depigmentation) in 12 % and poor response (< 50 % depigmentation) in 8 % of the cases. Minor adverse effects were reported e.g. burning sensation, erosions and local infection.

Conclusions: TCA seems to be a cost-effective and well tolerated therapeutic option for the treatment of recalcitrant residual pigmentation in patients with extensive vitiligo. This modality is associated with reduced downtime and minimal adverse effects.