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

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.

To compare the efficacy and safety of IMTA versus OMP-D in adults with active vitiligo.

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.

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.

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.