Beneficial UVB phototherapy preceding a fractional CO2 laser‐UVB protocol in refractory non‐segmental vitiligo.

Autor: Helou, Josiane, Soutou, Boutros, Maatouk, Ismael, Merhy, Reine, Assaf, Joy, Sarkis, Anne‐Sophie, Jabbour, Rita, Kaikati, Jérôme, Tomb, Roland
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Zdroj: Journal of Cosmetic Dermatology; Dec2022, Vol. 21 Issue 12, p6783-6787, 5p
Abstrakt: Objectives: To explore the short‐ and long‐term effects of UVB phototherapy preceding a fractional CO2 laser‐UVB protocol in patients with resistant nonsegmental vitiligo. Materials and Methods: This single‐center, prospective, split‐face/body, evaluator‐blinded study included adult patients with stable vitiligo refractory to conventional treatments. Two symmetrical lesions were selected. Phototherapy was delivered with one side covered, until minimal erythema. Within 3 days, 31‐month‐apart sessions of laser were performed on both sides. After each laser session, phototherapy was resumed three times weekly, with all lesions uncovered, until 8 weeks after the last laser session. At baseline, at the end of treatment, and 5 years later, a Mean Improvement Score by Physician (MISP) and a patient satisfaction 10‐point visual analog score (VAS) were recorded. Results: Ten patients (8 women and 2 men) were included; their mean age was 32.9 years; phototype III was predominant; the mean duration of vitiligo was 3 years. At the end of treatment and 5 years later, scores of lesions treated with UVB‐CO2‐UVB (mean MISP 3.0 and 2.9, mean ΔVAS 4.5 and 3.9, respectively), were higher than those of lesions treated only with CO2‐UVB (mean MISP 2.5 and 2.4, mean ΔVAS 4.1 and 3.6, respectively). After 5 years, one patient lost his partial response and two patients developed light hyperpigmentation on both sides. Conclusion: Exposure to UVB before CO2‐UVB explains the higher scores as it was the only variable between the two sides. It may improve the response of resistant lesions with a constantly sustained result over 5 years. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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