Study the effect of erbium:YAG laser plus topical 5-flurouracil in stable vitiligo resistant to NB-UVB phototherapy.

Autor: Doghaim NN; Faculty of Medicine, Tanta University, Tanta, Egypt., El-Tatawy RA; Faculty of Medicine, Tanta University, Tanta, Egypt., Ismail MA; Faculty of Medicine, Tanta University, Tanta, Egypt., Ali DAM; Faculty of Medicine, Tanta University, Tanta, Egypt., El Attar YA; Faculty of Medicine, Tanta University, Tanta, Egypt.
Jazyk: angličtina
Zdroj: Journal of cosmetic dermatology [J Cosmet Dermatol] 2020 Jan; Vol. 19 (1), pp. 122-130. Date of Electronic Publication: 2019 Oct 01.
DOI: 10.1111/jocd.13134
Abstrakt: Background: NB-UVB phototherapy is still an effective treatment in vitiligo but requires more than 1 year for its completion. Topical 5-flurouracil could improve the proliferation and migration of melanocytes. Laser-assisted dermabrasion results in stimulation of the inactive melanocytes present at the outer root sheath of the lower portion of the hair follicle, which migrates upward until they reach the surface of the skin.
Objective: To evaluate the effect of Er:YAG laser skin ablation followed by topical 5-flurouracil on the outcome of NB-UVB phototherapy as a short term technique in resistant and stable vitiligo.
Methods: The current study included 40 patients suffering from bilateral stable vitiligo resistant to NB-UVB. For each patient, one side of the body subjected to 4 months NB-UVB sessions (control side). While the other side of the body subjected to one session of Er:YAG laser ablation combined with topical 5% 5-flurouracil application under occlusion followed by NB-UVB sessions for 4 months after complete re-epithelization. Outcomes were evaluated objectively based on standard digital photographs, histopathological examination, patient satisfaction, and adverse effects.
Results: There was a statistically significant improvement in the repigmentation in laser side compared with control side. Histopathological examination revealed expression of prominent melanin pigmentation, with marked expression for Melan-A in laser side, whereas these findings were negative in control side.
Conclusion: Er:YAG laser ablation, followed by 5FU application before NB-UVB phototherapy for vitiligo, is a safe and tolerable technique that improves the outcome of short-term NB-UVB therapy and is expected to increase patient compliance.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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