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Vitiligo — SCE Dermatology MCQ

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ModerateInflammatory DermatosesVitiligoSCE Dermatology

A 45-year-old woman with extensive vitiligo affecting >50% BSA asks about treatment options. What is the most appropriate treatment approach for extensive vitiligo?

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Correct answer: D — Narrowband UVB phototherapy

For extensive vitiligo (>50% BSA), NB-UVB phototherapy is the most practical and evidence-based treatment. Treatment 2-3 times weekly for at least 6-12 months is needed to assess response. Depigmentation with Monobenzyl ether of hydroquinone (MBEH) is reserved for very extensive vitiligo (>80% BSA) where the patient prefers complete depigmentation — this is irreversible. Topical therapies are impractical for extensive disease. Surgical melanocyte transplantation is appropriate for stable, segmental, or localised vitiligo unresponsive to medical therapy, not extensive active disease.

Reference: BAD 2021 Vitiligo Guidelines; NICE