Esmat SM, Bassiouny D, Hegazy R, et al. - For cases of recent localized vitiligo, early systemic immunomodulation affords a successful management option to achieve early control of disease activity as well as minimize the incidence of recurrence. Early management of such cases is crucial; it is a race against time.

• This study involved 25 patients with recent onset (<6 months), localized (<2% BSA) vitiligo (84% of patients had acrofacial lesions and 44% had facial lesions); they were treated with pulse dexamethasone therapy for 6 months plus topical treatments and NB-UVB sessions.

• Following 3.65 ± 2.19months of treatment, arrest of activity was achieved.

• Patients achieved complete repigmentation in a mean span of 6.88 ± 0.2months.

• Occurrence of recurrence in 32% of patients was revealed at the end of the 4-year follow up.

• Despite recurrence; localized disease (<2% BSA) was secured.

• A significantly higher incidence of recurrence was found to be related to cases with bilateral distribution of lesions.