1
|
Saad MA, Tawfik KM, Abdelaleem HL. Efficacy and safety of micro-needling combined with topical 5-fluorouracil and excimer light vs. excimer light alone in treatment of non-segmental vitiligo: A comparative study. J Cosmet Dermatol 2023; 22:810-821. [PMID: 36343160 DOI: 10.1111/jocd.15481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/19/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/PURPOSE Vitiligo is one of the most challenging dermatological diseases with little improvement promises. Various modalities of treatment both medical and surgical have been used in the treatment of vitiligo. Some proved to be effective, others with controversial results and the rest were effective less. The aim of the present study was to evaluate the additional effect of topical 5-fluorouracil after micro-needling to excimer light (308 nm) in treatment of non-segmental vitiligo. METHODS Fifty patients were included in the present study, only 33 patients continued the treatment for 6 months. Two patches were selected in every patient to be treated, one patch with micro-needling then application of 5 FU and excimer (Group A), and the other with excimer only (Group B). RESULTS The treatment with the combination of micro-needling then application of 5 FU and excimer showed significant earlier response versus excimer alone. Also, the percentage of re-pigmentation was higher in the patches treated with the combination especially in the face and trunk. The combination of 5 FU after micro-needling and Excimer is more suitable for localized and focal vitiligo. CONCLUSION Topical 5 FU after micro-needling is a promising, rapid, and cost-effective therapeutic strategy for treatment of non-segmental vitiligo It had limited side effects, and the best response was reported for lesions affecting face and trunk.
Collapse
Affiliation(s)
- Mohammad A Saad
- Department of Dermatology, Venerology, and Andrology, Faculty of Medicine Al-Azhar University (Assiut), Assiut, Egypt
| | - Khaled Mohamed Tawfik
- Department of Dermatology, Venerology, and Andrology, Faculty of Medicine Al-Azhar University (Assiut), Assiut, Egypt
| | - Hazem L Abdelaleem
- Department of Dermatology, Venerology, and Andrology, Faculty of Medicine Al-Azhar University (Assiut), Assiut, Egypt
| |
Collapse
|
2
|
Pazyar N, Hatami M, Yaghoobi R, Parvar SY, Radmanesh M, Hadibarhaghtalab M. The efficacy of adding topical 5-fluorouracil to micro-needling in the treatment of vitiligo: A randomized controlled trial. J Cosmet Dermatol 2023; 22:1513-1520. [PMID: 36718813 DOI: 10.1111/jocd.15616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/03/2022] [Accepted: 12/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIM Vitiligo is an autoimmune skin disorder characterized by circumscribed depigmented macules and patches caused by the loss of functional melanocytes. Although there is no definitive treatment for vitiligo, several treatment options have been associated with relative satisfactory outcomes. The purpose of this study was to compare the efficacy of micro-needling in conjunction with topical 5-fluorouracil (5-FU) versus topical tacrolimus ointment in treating vitiligo patches. PATIENTS AND METHODS This study included nineteen participants, each of whom received both treatments on two randomly selected vitiligo patches of approximately the same size and location. On one patch, a combination of weekly micro-needling and topical application of 5-FU solution was used every other day, while on the other, 0.1% tacrolimus topical ointment was applied twice daily. The G-score was used to compare treatment outcomes after 3 months. RESULTS The median duration of the disease in our population was 7 years. Six patients (32%) in the micro-needling plus topical 5-FU treated group showed a moderate to excellent response, indicating a significant improvement between both treatments (p-value = 0.019). In contrast, all other patches treated with topical tacrolimus showed poor improvement. Lower extremity and trunk responded more to treatment with micro-needling plus topical 5-FU than upper extremity and acral areas. Moreover, none of those who have had the disease for more than ten years have responded to treatment. Mild erythema, pinpoint bleeding, and irritation were detected only in the micro-needling treated group. CONCLUSION The current study showed that using micro-needling in conjunction with 5-FU could treat vitiligo patients more efficiently than tacrolimus monotherapy. Despite showing moderate to excellent improvement in patches treated with micro-needling and 5-FU, this well-tolerated office-based modality still requires additional research.
Collapse
Affiliation(s)
- Nader Pazyar
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hatami
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Yaghoobi
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyedeh Yasamin Parvar
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of medical sciences, Shiraz, Iran
| | - Mohammad Radmanesh
- Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Hadibarhaghtalab
- Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Albalat W, Elsayed M, Salem A, Ehab R, Fawzy M. Microneedling and
5‐Flurouracil
Can Enhance the Efficacy of
Non‐Cultured
Epidermal Cell Suspension Transplantation for Resistant Acral Vitiligo. Dermatol Ther 2022; 35:e15768. [DOI: 10.1111/dth.15768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Waleed Albalat
- Department of Dermatology Venereology and Andrology, Faculty of Medicine, Zagazig University Zagazig Egypt
| | - Manal Elsayed
- Department of Dermatology Venereology and Andrology, Faculty of Medicine, Zagazig University Zagazig Egypt
| | - Amira Salem
- Dermato‐Pathology Department Faculty of Medicine, Zagazig University Zagazig Egypt
| | - Rana Ehab
- Department of Dermatology Venereology and Andrology, Faculty of Medicine, Zagazig University Zagazig Egypt
| | - Manal Fawzy
- Department of Dermatology Venereology and Andrology, Faculty of Medicine, Zagazig University Zagazig Egypt
| |
Collapse
|
4
|
Abasifar H, Ghalamkarpour F, Diab R, Abdollahimajd F. Evaluation of Combination use of phenytoin Cream 1% and Fractional CO 2 laser in Treatment of Stable Non-Segmental Vitiligo: A Pilot Study. Dermatol Ther 2022; 35:e15635. [PMID: 35699662 DOI: 10.1111/dth.15635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Vitiligo is an autoimmune disorder of melanocyte characterized by macular and depigmented patches. There are several treatment modalities for this disease, including the use of corticosteroids, calcineurin inhibitors, vitamin D analogous and topical phenytoin. Combination therapy utilizing fractional CO2 laser with different topical agents has been used to enhance treatment response with promising results. In this study, we aimed to evaluate the effect of fractional CO2 laser in combination with topical phenytoin. METHODS In this study, 25 patients (11 females and 14 males) with age of 18 to 59 (mean age of 31.12) with non-segmental stable vitiligo were recruited with insufficient response to at least one-year treatment with a monotherapy using topical corticosteroids, calcineurin inhibitors, and/or NB-UVB phototherapy. Patients were treated with a combination of fractional CO2 laser (10600 nm, pulse energy 30 to 50 mJ, MIXEL, South Korea, Rating: 220VAC, 3A, 50/60Hz) with monthly intervals for 6 sessions and application of phenytoin 1% cream twice daily. Photography was done before and after treatment with Wood's lamp. The severity of disease using VASI score was calculated and compared before and after treatment. RESULTS The mean VASI score before treatment was 0.55, and sixth month after treatment increased to 1.97 (p-value <0.001). Patients were divided into three groups based on the vitiligo subtype: acral, upper extremities, and trunk. VASI score was measured in each group: VASI score before and after treatment was 0.50 and 1.48 in acral areas, 0.45 and 2.04 in upper extremities and 0.79 and 3.39 in trunk, respectively. CONCLUSIONS This study revealed that combination therapy with phenytoin and fractional CO2 laser is effective in treatment of vitiligo not only in the upper extremities and trunk, but also interestingly in the acral areas. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Hajar Abasifar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Ghalamkarpour
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reem Diab
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Elgarhy LH, El-Tatawy RA, Ali DM, Anber DM, Iskandarani YA, Ismail MA. Treatment of stable nonsegmental vitiligo using transdermal delivery of 5-fluorouracil by fractional CO 2 laser versus intralesional injection of 5-fluorouracil, both followed by narrow-band type ultraviolet B (UVB): A comparative study. J Cosmet Dermatol 2022; 21:3832-3841. [PMID: 35005831 DOI: 10.1111/jocd.14691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Updates of treatment methods of stable vitiligo are needed to give better outcomes with a shorter duration of treatment. OBJECTIVE To test the effect of transdermal 5-fluorouracil (5-FU) delivery using fractional CO2 (FrCO2 ) laser versus intralesional 5-FU injection, with narrow-band type ultraviolet B (UVB) (NB-UVB) therapy after both, in the treatment of stable vitiligo. PATIENTS AND METHODS The present study comprised 40 patients with nearly symmetrical stable vitiligo lesions. The left side was treated with FrCO2 laser followed by topical 5-FU (FrCO2 + 5-FU), while the right side was treated with 5-FU intradermal injection. Both procedures were done at 2-week intervals for 3 sessions followed by 24 sessions of narrow-band UVB for both sides. RESULTS Repigmentation was demonstrated on the left side of 90% of patients and the right side of 85% of patients. As much as >50% improvement was demonstrated on the left side of 50% of patients, and the right side of 55% of patients. Intralesional 5-FU showed a statistically significant difference in repigmentation compared to FrCO2 + 5-FU. CONCLUSION Both 5-FU injection and FrCO2 + 5-FU were effective therapeutic modalities for vitiligo. Patients were more compliant with FrCO2 + 5-FU.
Collapse
Affiliation(s)
- Lamia H Elgarhy
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rania A El-Tatawy
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dareen M Ali
- Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Doha M Anber
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Mayada A Ismail
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|
6
|
Mohammadi S, Amiri R, Khalili M, Iranmanesh B, Aflatoonian M. Treatment protocols and efficacy of combined laser with medical treatment modalities in vitiligo. J Cosmet Dermatol 2021; 21:3272-3291. [PMID: 34766697 DOI: 10.1111/jocd.14602] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUNDS Nowadays, lasers are used for treatment of vitiligo in difficult-to-treat areas and refractory lesions. Combination of lasers with other medical modalities can provide higher efficacy, faster response rate, and higher compliance of patients to treatment. AIM In this article, we reviewed articles regarding safety, efficacy, and treatment protocols of combined laser with other medical modalities. METHODS We searched articles with relevant key words in Google scholar and PubMed. Inclusion criteria were articles in English language since January 2000 until March 2021that evaluate combination of laser with other topical or systemic medical treatments. RESULTS A total of 42 articles evaluated efficacy of lasers [excimer, carbon dioxide (CO2 ), erbium-doped yttrium-aluminum-garnet (Er:YAG), and non-ablative resurfacing laser] combined with topical or systemic medical treatment modalities. Effective response rate (more than 50% improvement) varied between 7.7% and 92%. Initial repigmentation observed between 4 and 13 weeks after beginning of treatment. CONCLUSION Combination of laser with medical modalities leads to more rapid repigmentation, superior efficacy, and better compliance of patients with localized non-segmental type of vitiligo compared to monotherapy. Combination of excimer laser with topical therapy might be suggested for recalcitrant vitiligo lesions in face and neck. Combination of fractional ablative resurfacing lasers with topical therapy, especially 5-flurouracil, can be recommended particularly in recalcitrant acral and bony prominent areas. Further studies are required to achieve conclusive evidence in order to define the best stage of vitiligo for laser therapy and most effective combined treatment regimen.
Collapse
Affiliation(s)
- Saman Mohammadi
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Behzad Iranmanesh
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
7
|
Pro-pigmentary action of 5-fluorouracil through the stimulated secretion of CXCL12 by dermal fibroblasts. Chin Med J (Engl) 2021; 134:2475-2482. [PMID: 34507320 PMCID: PMC8654429 DOI: 10.1097/cm9.0000000000001689] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: There is growing evidence that 5-fluorouracil (5-FU) combined with therapeutic trauma can effectively induce skin repigmentation in vitiligo patients who are unresponsive to conventional treatments. Previous studies have mainly focused on identifying the antimitotic activity of 5-FU for the treatment of skin cancer, but few studies have investigated its extra-genotoxic actions favoring melanocyte recruitment. Methods: We utilized the full thickness excisional skin wound model in Dct-LacZ transgenic mice to dynamically assess the migration of melanocytes in the margins of wounds treated with or without 5-FU. The in-situ expression of CXCL12 was examined in the wound beds using immunofluorescence staining. Quantitative real-time polymerase chain reaction and Western blotting analyses were performed to detect the expression levels of CXCL12 mRNA and protein in primary mouse dermal fibroblasts treated with or without 5-FU. Transwell assays and fluorescein isothiocyanate (FITC)-phalloidin staining were used to observe cell migration and filamentous actin (F-actin) changes of melan-a murine melanocytes. Results: Whole mount and cryosection X-gal staining showed that the cell numbers of LacZ-positive melanocytes were much higher in the margins of dorsal and tail skin wounds treated with 5-FU compared with the controls. Meanwhile, CXCL12 immunostaining was significantly increased in the dermal compartment of wounds treated with 5-FU (control vs. 5-FU, 22.47 ± 8.85 vs. 44.69 ± 5.97, P < 0.05). Moreover, 5-FU significantly upregulated the expression levels of CXCL12 mRNA (control vs. 5-FU, 1.00 ± 0.08 vs. 1.54 ± 0.06, P < 0.05) and protein (control vs. 5-FU, 1.00 ± 0.06 vs. 2.93 ± 0.10, P < 0.05) in cultured fibroblasts. Inhibition of the CXCL12/CXCR4 axis suppressed melanocyte migration in vitro using a CXCL12 small interfering RNA (siRNA) or a CXCR4 antagonist (AMD3100). Conclusion: 5-FU possesses a pro-pigmentary activity through activation of the CXCL12/CXCR4 axis to drive the chemotactic migration of melanocytes.
Collapse
|
8
|
Kubelis-López DE, Zapata-Salazar NA, Said-Fernández SL, Sánchez-Domínguez CN, Salinas-Santander MA, Martínez-Rodríguez HG, Vázquez-Martínez OT, Wollina U, Lotti T, Ocampo-Candiani J. Updates and new medical treatments for vitiligo (Review). Exp Ther Med 2021; 22:797. [PMID: 34093753 PMCID: PMC8170669 DOI: 10.3892/etm.2021.10229] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/18/2021] [Indexed: 12/16/2022] Open
Abstract
Vitiligo is a multifactorial disease characterized by the loss of skin pigment, which results in achromic macules and patches. There are currently several medical treatments available, which aim to arrest progression and induce skin repigmentation. These treatments alone or combined have exhibited varying degrees of pigmentation, and the majority are safe and effective. All therapies for vitiligo are limited, and no known treatment can consistently produce repigmentation in all patients. Individualized treatment is appropriate according to the location, clinical presentation and the presence of disease activity. The present review summarizes the medical treatments available for vitiligo: Systemic and topic pharmacological therapies, physical and depigmentation treatments. Several treatments are still underway and have not yet been approved. However, due to the promising preliminary results, these are also mentioned in the present review.
Collapse
Affiliation(s)
- David Emmanuel Kubelis-López
- Department of Dermatology, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Natalia Aranza Zapata-Salazar
- Department of Dermatology, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Salvador Luis Said-Fernández
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Celia Nohemí Sánchez-Domínguez
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | | | - Herminia Guadalupe Martínez-Rodríguez
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Osvaldo Tomás Vázquez-Martínez
- Department of Dermatology, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| | - Uwe Wollina
- Department of Dermatology and Allergology and Skin Cancer Center, Städtisches Klinikum Dresden, D-01067 Dresden, Germany
| | - Torello Lotti
- Department of Dermatology and Venereology, University of Rome G. Marconi, I-00193 Rome, Italy.,Department of Dermatology and Communicable Diseases, First Medical State University of Moscow I. M. Sechenev Ministry of Health, Moscow 119991, Russia
| | - Jorge Ocampo-Candiani
- Department of Dermatology, Faculty of Medicine and University Hospital 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Nuevo León 64460, México
| |
Collapse
|
9
|
Awad SS. Seven strategies for the management of depigmented skin according to the etiopathogenesis. J Cosmet Dermatol 2021. [DOI: 10.1111/jocd.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sherif S. Awad
- Dermatology & Venereology Department Faculty of Medicine Minia University Minia Egypt
| |
Collapse
|
10
|
Choudhary P, Singrodia A, Mehta R, Sharma D, Ghiya B, Bai S J. Microneedling with topical 5-fluorouracil in the localized stable vitiligo – Is this the way out? – Our experience: A hospital-based study. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2021. [DOI: 10.4103/jdds.jdds_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Bakr RM, Abdel-Gaber RM, Tawfik YM. A comparative study on the use of fractional CO 2 laser with tacrolimus or calcipotriol or narrow band ultraviolet-B in treatment of stable nonsegmental vitiligo. Dermatol Ther 2020; 34:e14604. [PMID: 33249712 DOI: 10.1111/dth.14604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
Conventional methods of treatment for vitiligo are often unsatisfactory to the patients and time consuming, new treatment modalities are needed. This study was conducted to evaluate the efficacy and safety of fractional carbon dioxide (CO2 ) laser therapy followed by narrow band ultraviolet-B (NB-UVB) phototherapy, topical tacrolimus or topical calcipotriol on stable nonsegmental vitiligo. Thirty patients with stable nonsegmental vitiligo were evaluated. All patients were subjected to three sessions of fractional CO2 laser 1 month apart. Patients were divided into three groups (each group 10 patients). Group (A) treated with tacrolimus ointment twice daily for 3 months, group (B) treated with calcipotriol ointment twice daily for 3 months, and group (C) treated with NB-UVB twice weekly for 3 months. Outcomes were evaluated by calculating vitiligo area scoring index (VASI) score change, percentage of repigmentation, patient satisfaction, and adverse effects. There was a statistical significant decrease in VASI score after treatment in the three groups. The VASI change and % of regimentation was higher in group (C) treated by laser and NB-UVB and this was significantly higher than group (B) treated with laser and calcipotriol. Otherwise, there was no statistical significant difference between other treatment groups. In concluion, NB-UVB phototherapy, topical tacrolimus, or topical calcipotriol in combination with fractional CO2 laser could be used effectively and safely as an alternative modality for treatment of vitiligo. The combination of fractional CO2 laser and NB-UVB was found to be more effective.
Collapse
Affiliation(s)
- Radwa M Bakr
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | - Reham M Abdel-Gaber
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| | - Yasmin M Tawfik
- Department of Dermatology, Venereology and Andrology, Assiut University, Assiut, Egypt
| |
Collapse
|
12
|
Zahra FT, Adil M, Amin SS, Mohtashim M, Bansal R, Khan HQ. Efficacy of Topical 5% 5-Fluorouracil with Needling versus 5% 5-Fluorouracil Alone in Stable Vitiligo: A Randomized Controlled Study. J Cutan Aesthet Surg 2020; 13:197-203. [PMID: 33208995 PMCID: PMC7646419 DOI: 10.4103/jcas.jcas_12_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Vitiligo is a chronic disease of great cosmetic concern presenting with depigmented macules and patches. It is often recalcitrant to medical treatment. Aim: The aim of the study was to study the efficacy and safety of topical 5% 5-fluorouracil with needling versus topical 5% 5-fluorouracil alone in stable vitiligo. Materials and Methods: This interventional prospective study was conducted from July 2018 to June 2019. Total of 60 patients, with stable vitiligo of age older than 10 years, were randomly assigned into two groups of 30 patients each. Group A was treated with needling followed by topical 5% 5-fluorouracil over vitiligo patches. The procedure was performed every 2 weeks for 3 months. Group B was treated with topical 5% 5-fluorouracil alone. Clinical improvement was assessed monthly till 6 months by serial clinical photographs and grading score. Results: Initiation of repigmentation started at 1 month in 76 patches (65%) in Group A, whereas in group B, it was seen in 45 patches (38.7%), which was statistically significant (P = 0.0001). Excellent improvement (>75% repigmentation) was noted in 55 patches (47%) in Group A as compared to 5 patches (4.3%) in group B at the end of 6 months (P = 0.03). Conclusion: Needling with 5% 5-fluorouracil appears to be simple, safe, and effective treatment in vitiligo. It can be used in poor responders to conventional therapy.
Collapse
Affiliation(s)
- Fatima T Zahra
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| | - Mohammad Adil
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| | - Syed S Amin
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| | - Mohd Mohtashim
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| | - Roopal Bansal
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| | - Hania Q Khan
- Department of Dermatology, Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, Uttar Pradesh, India
| |
Collapse
|
13
|
The efficacy of fractional carbon dioxide laser combined with narrow-band ultraviolet B phototherapy for non-segmental vitiligo: a systematic review and meta-analysis. Lasers Med Sci 2020; 36:165-173. [PMID: 32572662 DOI: 10.1007/s10103-020-03069-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
Fractional carbon dioxide (CO2) laser has been used with conventional treatments for vitiligo, demonstrating more effectiveness compared with conventional treatments alone. Especially, fractional CO2 laser combined with narrow-band ultraviolet B (NB-UVB) was shown to induce more improvement compared with NB-UVB monotherapy for treating stable non-segmental vitiligo. However, the effectiveness of fractional CO2 laser plus NB-UVB for the treatment of non-segmental vitiligo remains controversial. Therefore, this study aimed to confirm the safety and efficacy of fractional CO2 laser combined with NB-UVB compared with NB-UVB monotherapy in stable non-segmental vitiligo. We searched the data from different databases, including Cochrane, Embase, and PubMed up to January 2020. Four randomized controlled trials (RCTs) for comparison between fractional CO2 laser plus NB-UVB and NB-UVB monotherapy in patients with stable non-segmental vitiligo were included. We performed meta-analyses for repigmentation improvement and patient satisfaction as well as subgroup analyses based on acral or non-acral vitiligo, according to the PRISMA guidelines. The combination treatment showed more superior results than NB-UVB monotherapy (≥ 75% repigmentation, RR 4.60, 95% CI 1.19-17.74; ≥ 50% repigmentation, RR 2.24, 95% CI 0.45-11.17; < 25% repigmentation, RR 0.81, 95% CI 0.60-1.08). Also, fractional CO2 laser plus NB-UVB significantly improved acral and non-acral vitiligo compared with NB-UVB monotherapy (standard mean difference (SMD) 1.24, 95% CI 0.66-1.82; SMD 1.14, 95% CI 0.67-1.60, respectively), while it increased markedly patient satisfaction compared with NB-UVB monotherapy (SMD 1.12, 95% CI 0.66-1.58). Collectively, this meta-analysis suggested that fractional CO2 laser combined with NB-UVB might be more effective for treating non-segmental vitiligo than NB-UVB monotherapy.
Collapse
|
14
|
Abdelwahab M, Salah M, Samy N, Rabie A, Farrag A. Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo. Clin Cosmet Investig Dermatol 2020; 13:77-85. [PMID: 32021372 PMCID: PMC6988583 DOI: 10.2147/ccid.s225881] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 11/29/2019] [Indexed: 11/30/2022]
Abstract
Purpose To compare the efficacy of topical 5-FU as monotherapy to combined therapy of topical 5-FU and Er:YAG (2940 nm) laser in the treatment of non-segmental vitiligo (NSV). Methods This is a prospective randomized comparative study. Thirty patients diagnosed with NSV were recruited from the dermatology outpatient clinics of the Medical Research Centre of Excellence, the National Research Centre and the National Institute of Laser Enhanced Sciences. Our study group was divided into two subgroups, Group 1 was subjected to ablative Er:YAG and 5-FU cream and Group 2 applied topical 5-FU cream. Three treatment sessions were repeated every 4 to 6 weeks and patients were followed up to 9 months. Repigmentation was assessed by digital photography and subsequent computer based image analysis. Results Repigmentation of Group 1 patients ranged from 0 to 70% (mean 12±7%) whilst in Group 2 this ranged from 0 to 5% (mean 1.4±0.8%). In Group 1 repigmentation was mild in 22/30 (73.3%) and moderate to severe in 3/30 (10%) starting after 3 months and persisted or increased during the period of follow up to 9 months. Groups 1 and 2 were subdivided into A and B, vitiligo involving non-resistant and resistant areas respectively. Group 1A showed more repigmentation (mean 13.8±8.5%) than Group 1B (mean 9.8±4.5%) and Group 2A showed more repigmentation (mean 1.5±1%) than Group 2B (mean 1.3±0.5%). Conclusion The combination of Er:YAG with 5-FU is safe and effective in treating and improving outcome in vitiligo especially of non-resistant areas. Computer based image analysis of vitiliginous lesions and assessing post-therapy response is an easy, quick, and reliable method. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/RNPmA6PkfGo
Collapse
Affiliation(s)
- Mahetab Abdelwahab
- Department of Dermatology and Venereology, Medical Division, National Research Centre, Cairo, Egypt
| | - Manal Salah
- Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Nevien Samy
- Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Ahmad Rabie
- Department of Dermatology and Venereology, Medical Division, National Research Centre, Cairo, Egypt
| | - Abdelrazik Farrag
- Department of Pathology, Medical Division, National Research Centre, Cairo, Egypt
| |
Collapse
|
15
|
King YA, Tsai TY, Tsai HH, Huang YC. Wirksamkeit einer ablationsbasierten Kombinationstherapie bei Vitiligo: Eine systematische Übersichtsarbeit und Metaanalyse. J Dtsch Dermatol Ges 2019; 16:1197-1210. [PMID: 30300497 DOI: 10.1111/ddg.13657_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Yih-An King
- Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Tsung-Yu Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsiou-Hsin Tsai
- Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Chen Huang
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
16
|
Attwa EM, Khashaba SA, Ezzat NA. Evaluation of the additional effect of topical 5‐fluorouracil to needling in the treatment of localized vitiligo. J Cosmet Dermatol 2019; 19:1473-1478. [DOI: 10.1111/jocd.13152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/24/2019] [Accepted: 08/27/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Enayat Mohamed Attwa
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| | - Shrook A. Khashaba
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| | - Nehal Anwar Ezzat
- Dermatology, Venereology and Andrology Department Faculty of Medicine Zagazig University Zagazig Egypt
| |
Collapse
|
17
|
Ghasemloo S, Gauthier Y, Ghalamkarpour F. Evaluation of using fractional CO 2 laser plus NB-UVB versus NB-UVB alone in inducing marginal repigmentation of vitiligo lesions. J DERMATOL TREAT 2019; 30:697-700. [PMID: 30592235 DOI: 10.1080/09546634.2018.1564232] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Vitiligo is a common depigmenting skin disorder, characterized by patchy loss of skin color and finding effective treatment has remained a challenging issue. Methods: A paired (half-body) randomized clinical trial study was done to compare the efficacy and the safety of narrowband ultraviolet B (NB-UVB) plus fractional CO2 versus NB-UVB alone in stimulation of marginal repigmentation of vitiliginous patches. One side of the body was randomly treated with a fractional CO2 laser and NB-UVB twice weekly, while the other side was exposed only to NB-UVB with the same manner. Results: Thirty patients with the nonsegmental stable vitiligo and mean age of 43 ± 15 years completed a 16-week treatment period with NB-UVB on one side of the body and fractional CO2 laser therapy with NB-UBV on the other side. In addition to the higher rate of response in the combination side compared to the monotherapy side of the body (p < .001), repigmentation was greater in the combination side rather than the NB-UVB monotherapy side (p = .002). In the combination treated side, marginal repigmentation pattern was more frequently seen than perifollicular pattern (p < .001) and more frequently than monotherapy side (p < .001). Conclusion: The fractional CO2 laser combined with NB-UVB seems to be a more effective therapeutic option for treatment than NB-UVB alone for inducing marginal repigmentation.
Collapse
Affiliation(s)
- Sara Ghasemloo
- a Skin Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Yvon Gauthier
- b Vitiligo and Melasma Research Association , Bordeaux , France
| | - Fariba Ghalamkarpour
- a Skin Research Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran
| |
Collapse
|
18
|
Alegre-Sánchez A, Jiménez-Gómez N, Boixeda P. Laser-Assisted Drug Delivery. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2018.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
|
19
|
Alegre-Sánchez A, Jiménez-Gómez N, Boixeda P. Vehiculización de fármacos asistida por láser. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:858-867. [DOI: 10.1016/j.ad.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 02/02/2023] Open
|
20
|
Liu L, Wu Y, Zhang J, Gu H, Luan Q, Qian L, Wang Y, Gao L, Wang H, Xiao B, Sun Y, Li H, Chen K, Zeng F, Li C, Gao T, Gao XH. Ablative fractional Co2 laser aided delivery of long-acting glucocorticoid in the treatment of acral vitiligo: a multicenter, prospective, self-bilateral controlled study. J DERMATOL TREAT 2018; 30:320-327. [PMID: 30081694 DOI: 10.1080/09546634.2018.1509048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ling Liu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yan Wu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jianzhong Zhang
- Department of Dermatology, Peking University People’s Hospital, Beijing, China
| | - Heng Gu
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China
| | - Qi Luan
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Linhan Qian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yanting Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Lin Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Hongyi Wang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Bihuan Xiao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yan Sun
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Houmin Li
- Department of Dermatology, Peking University People’s Hospital, Beijing, China
| | - Kun Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China
| | - Fanqin Zeng
- Department of Dermatology, Sun Yet-Sen Memorial Hospital of Sun Yet-Sen University, Guangzhou, China
| | - Chunying Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xing-Hua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
21
|
King YA, Tsai TY, Tsai HH, Huang YC. The efficacy of ablation-based combination therapy for vitiligo: A systematic review and meta-analysis. J Dtsch Dermatol Ges 2018; 16:1197-1208. [DOI: 10.1111/ddg.13657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/19/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Yih-An King
- Department of Dermatology; Taipei Medical University Hospital; Taipei Taiwan
| | - Tsung-Yu Tsai
- Department of Dermatology; Wan Fang Hospital, Taipei Medical University; Taipei Taiwan
| | - Hsiou-Hsin Tsai
- Department of Dermatology; Taipei Medical University Hospital; Taipei Taiwan
| | - Yu-Chen Huang
- Department of Dermatology; Wan Fang Hospital, Taipei Medical University; Taipei Taiwan
- Department of Dermatology, School of Medicine, College of Medicine; Taipei Medical University; Taipei Taiwan
| |
Collapse
|
22
|
Doghaim NN, Gheida SF, El‐Tatawy RA, Mohammed Ali DA. Combination of fractional carbon dioxide laser with narrow band ultraviolet B to induce repigmentation in stable vitiligo: A comparative study. J Cosmet Dermatol 2018; 18:142-149. [DOI: 10.1111/jocd.12553] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Noha Nabil Doghaim
- Faculty of Medicine Department of Dermatology and Venereology Tanta University Tanta Egypt
| | - Shereen Farouk Gheida
- Faculty of Medicine Department of Dermatology and Venereology Tanta University Tanta Egypt
| | - Rania Ahmed El‐Tatawy
- Faculty of Medicine Department of Dermatology and Venereology Tanta University Tanta Egypt
| | | |
Collapse
|
23
|
Chen W, Zhou Y, Huang FR, Luo D, Wang DG. Preliminary study on the treatment of vitiligo with carbon dioxide fractional laser together with tacrolimus. Lasers Surg Med 2018; 50:829-836. [PMID: 29635693 DOI: 10.1002/lsm.22821] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Wei Chen
- Department of Dermatology; The First Affiliated Hospital with Nanjing Medical University; Guangzhou Road 300, Nanjing City Jiangsu Province, China 210029
| | - Yuan Zhou
- Department of Dermatology; The First Affiliated Hospital with Nanjing Medical University; Guangzhou Road 300, Nanjing City Jiangsu Province, China 210029
| | - Fei-ran Huang
- Department of Dermatology; The First Affiliated Hospital with Nanjing Medical University; Guangzhou Road 300, Nanjing City Jiangsu Province, China 210029
| | - Dan Luo
- Department of Dermatology; The First Affiliated Hospital with Nanjing Medical University; Guangzhou Road 300, Nanjing City Jiangsu Province, China 210029
| | - Da-guang Wang
- Department of Dermatology; The First Affiliated Hospital with Nanjing Medical University; Guangzhou Road 300, Nanjing City Jiangsu Province, China 210029
| |
Collapse
|
24
|
Mina M, Elgarhy L, Al-saeid H, Ibrahim Z. Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo. J Cosmet Dermatol 2018. [DOI: 10.1111/jocd.12440] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mary Mina
- Faculty of Medicine; Department of Dermatology & Venereology; Tanta University; Tanta Egypt
| | - Lamia Elgarhy
- Faculty of Medicine; Department of pathology; Tanta University; Tanta Egypt
| | - Hanan Al-saeid
- Faculty of Medicine; Department of Dermatology & Venereology; Tanta University; Tanta Egypt
| | - Zeinab Ibrahim
- Faculty of Medicine; Department of Dermatology & Venereology; Tanta University; Tanta Egypt
| |
Collapse
|
25
|
Ibrahim O, Wenande E, Hogan S, Arndt KA, Haedersdal M, Dover JS. Challenges to laser-assisted drug delivery: Applying theory to clinical practice. Lasers Surg Med 2017; 50:20-27. [DOI: 10.1002/lsm.22769] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Omer Ibrahim
- SkinCare Physicians; Chestnut Hill Massachusetts 02467
| | - Emily Wenande
- Department of Dermatology; University of Copenhagen; Bispebjerg Hospital; Copenhagen Denmark
| | - Sara Hogan
- Department of Dermatology; Cleveland Clinic; Cleveland Ohio 04195
| | | | - Merete Haedersdal
- Department of Dermatology; University of Copenhagen; Bispebjerg Hospital; Copenhagen Denmark
| | | |
Collapse
|
26
|
Yan R, Yuan J, Chen H, Li YH, Wu Y, Gao XH, Chen HD. Fractional Er:YAG laser assisting topical betamethasone solution in combination with NB-UVB for resistant non-segmental vitiligo. Lasers Med Sci 2017; 32:1571-1577. [DOI: 10.1007/s10103-017-2282-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/05/2017] [Indexed: 12/26/2022]
|
27
|
Cunha PR, Scabine Pessotti N, Bonati Mattos C, Salai AF. New approach in the treatment of refractory vitiligo: CO 2 laser combined with betamethasone and salicylic acid solution. Dermatol Ther 2016; 30. [PMID: 27548998 DOI: 10.1111/dth.12410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The aim of this study is to evaluate the use of fractional carbon dioxide laser (CO2 ) with betamethasone and salicylic acid solution in the treatment of patients with refractory vitiligo in hands. Each hand of the patient was randomly assigned to one of two groups: lesion treated with fractional carbon dioxide laser associated with betamethasone and salicylic acid solution administration or lesion treated only with betamethasone and salicylic acid solution. We conclude that combined treatment with fractional carbon dioxide laser and betamethasone associated with salicylic acid solution could effectively and safely be used in the treatment of refractory vitiligo.
Collapse
Affiliation(s)
| | | | | | - Ana Flavia Salai
- Dermatology Department, Jundiaí Medical School, Sao Paulo, Brazil
| |
Collapse
|
28
|
Korobko IV, Lomonosov KM. A pilot comparative study of topical latanoprost and tacrolimus in combination with narrow-band ultraviolet B phototherapy and microneedling for the treatment of nonsegmental vitiligo. Dermatol Ther 2016; 29:437-441. [DOI: 10.1111/dth.12383] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Konstantin M. Lomonosov
- Department of Skin and Venereal Diseases, Therapeutic Faculty; I.M. Sechenov First Moscow State Medical University; Moscow Russia
| |
Collapse
|
29
|
A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo. Lasers Med Sci 2016; 31:1343-9. [DOI: 10.1007/s10103-016-1982-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
|