Intramuscular Triamcinolone Acetonide Versus Oral Minipulse Dexamethasone in Active Vitiligo: An Observational Study

Abstract

Background: Systemic corticosteroids, particularly oral minipulse dexamethasone (OMP-D), are commonly used to stabilize active vitiligo. Intramuscular triamcinolone acetonide (IMTA), though effective in other dermatoses, has limited studies for vitiligo. Objectives: To compare the efficacy and safety of IMTA versus OMP-D in adults with active vitiligo. Methods: This observational study included patients aged 18 to 60 years with clinically active vitiligo. Patients received either IMTA 40 mg monthly or OMP-D 2.5 mg twice weekly for 3 months. Vitiligo extent score (VES) and adverse events were assessed at baseline, months 1, 2, 3, and 6. Biochemical parameters were evaluated at baseline and month 3. Results: Nineteen patients (9 in the IMTA group and 10 in the OMP-D group) were included. All patients achieved disease stabilization within the first month. The IMTA group showed an earlier onset of repigmentation, evidenced by a significant reduction in VES at month 1. By months 2, 3, and 6, both groups demonstrated significant reductions in VES compared to baseline. Notably, at months 2 and 3, the OMP-D group exhibited a more pronounced decrease in VES (P ≤ .01) than the IMTA group (P ≤ .05). One patient in the IMTA group began to experience vitiligo relapse at month 6. Both treatments were well-tolerated. Cortisol suppression was observed in 1 patient from each group. Conclusions: IMTA shows promising results, comparable in efficacy and safety to OMP-D for active vitiligo, achieving early disease stabilization and repigmentation. IMTA represents a practical first-line alternative for active vitiligo management.