الفهرس 
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Abstract
Vitiligo is a common depigmenting skin disorder. It occurs secondary to the selective destruction of melanocytes by the body’s immune system. It was characterized by well-circumscribed, chalky white or milky macules or patches. The goal of vitiligo treatment is to regulate the response damage to melanocytes and stimulate their migration from close skin and body part reservoirs Microneedling (MN) or needle of the skin, is an aesthetic technique that has been used for decades before laser re-shows but has recently seen a surge in popularity, especially for ethnic skin. Microneedling has been effectively used for drug delivery and for treating many skin conditions and diseases Topical PUVA: A thin coat of psoralens cream or ointment at very low concentration (Ultramedanine paint 0.03g/15ml ) was first applied 30 minutes before UVA exposure This study aimed to: compare the efficacy of microneedling therapy with and without topical PUVA in treatment of patients with stable acral vitiligo The present study included 30 patients with acral stable non segmental vitiligo who were recruited from the Dermatology outpatients clinic. Assiut University Hospital. Assiut Egypt. Patients were divided into two groups group 1: Left side of 30 patients with 37 lesions treated by dermapen only. group 2: Right side of 26 patients with 26 lesions treated by dermapen with PUVA Each patient received 6 settings of microneedling at an interval of 1 month. The microneedling device used is (Dermapen).