Eficacia de la fototerapia en el tratamiento del vitíligo: revisión sistemática

Abstract

Background: Vitiligo is a chronic acquired skin disease characterized by the progressive loss of melanocytes and the appearance of depigmented macules. Its aesthetic, psychological, and social impact represents a therapeutic challenge. Phototherapy has demonstrated favorable results in repigmentation and disease stabilization. Objective: To evaluate the efficacy of phototherapy in the treatment of vitiligo in adults and children by analyzing the scientific evidence on the main therapeutic modalities. Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Randomized controlled trials published between 2007 and 2025, in English and Spanish, were included. Studies were identified through searches in PubMed, Scopus, Web of Science, and the Cochrane Library. Methodological quality and risk of bias were assessed using RoB 2. Results: Eighteen randomized controlled trials evaluating different phototherapy modalities were selected. Narrowband ultraviolet B (NB-UVB) was the most studied modality and showed better clinical results, particularly in facial and cervical lesions. Most studies reported repigmentation greater than 50% after six to twelve months of treatment. Combination therapies showed greater efficacy than monotherapy. Adverse effects were mainly mild and transient, with erythema and temporary hyperpigmentation being the predominant effects. Conclusion: Phototherapy, particularly NB-UVB, is an effective alternative in adults and children. However, methodological heterogeneity limits the comparison of results and highlights the need for research with standardized protocols. Keywords: phototherapy, excimer lasers, ultraviolet rays, repigmentation, vitiligo