Combination treatment by 10 600 nm ablative fractional carbon dioxide laser and narrowband ultraviolet B in refractory nonsegmental vitiligo: A prospective, randomized half-body comparative study

J. Shin, J. S. Lee, S. K. Hann, SangHo Oh

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background Vitiligo is a common acquired depigmentation disorder caused by the loss of melanocytes. Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed. Objectives To investigate the effects of fractional carbon dioxide (CO 2) laser therapy followed by systemic narrowband ultraviolet B (NB-UVB) phototherapy on nonsegmental vitiligo (NSV) as a prospective and randomized left-right comparative study. Methods Ten patients with NSV who presented symmetrical vitiligo lesions with no further improvement despite more than 1 year of conventional treatment were enrolled. Two sessions of half-body fractional CO 2 laser therapy were performed at a 2-month interval. NB-UVB phototherapy was then administered to the entire body 5 days after each fractional laser treatment twice a week, increasing the dose incrementally by 15% at each session. Objective clinical assessments were made by two blinded dermatologists using a quartile grading scale, and the patients' overall satisfaction was evaluated using a 10-point visual analogue scale. Results Two months after the last treatment, mean improvement scores, assessed by physicians, were significantly higher for those treated with half-body fractional CO 2 laser therapy followed by NB-UVB phototherapy, compared with those treated with NB-UVB alone (P = 0·034). In addition, according to subjective assessment, the half-body laser treatment followed by NB-UVB showed significantly higher improvements compared with NB-UVB treatment alone (P = 0·023). Noticeable adverse events, such as infection, scarring and Koebner phenomenon, were not found in any patient. Conclusions This study suggests that fractional CO 2 laser therapy followed by NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of refractory vitiligo.

Original languageEnglish
Pages (from-to)658-661
Number of pages4
JournalBritish Journal of Dermatology
Volume166
Issue number3
DOIs
Publication statusPublished - 2012 Mar 1

Fingerprint

Vitiligo
Gas Lasers
Phototherapy
Laser Therapy
Carbon Monoxide
Therapeutics
Lasers
Melanocytes
Visual Analog Scale
Patient Satisfaction
Carbon Dioxide
Cicatrix
Physicians

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

@article{89e370d3087e4faba0951abb56b5a133,
title = "Combination treatment by 10 600 nm ablative fractional carbon dioxide laser and narrowband ultraviolet B in refractory nonsegmental vitiligo: A prospective, randomized half-body comparative study",
abstract = "Background Vitiligo is a common acquired depigmentation disorder caused by the loss of melanocytes. Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed. Objectives To investigate the effects of fractional carbon dioxide (CO 2) laser therapy followed by systemic narrowband ultraviolet B (NB-UVB) phototherapy on nonsegmental vitiligo (NSV) as a prospective and randomized left-right comparative study. Methods Ten patients with NSV who presented symmetrical vitiligo lesions with no further improvement despite more than 1 year of conventional treatment were enrolled. Two sessions of half-body fractional CO 2 laser therapy were performed at a 2-month interval. NB-UVB phototherapy was then administered to the entire body 5 days after each fractional laser treatment twice a week, increasing the dose incrementally by 15{\%} at each session. Objective clinical assessments were made by two blinded dermatologists using a quartile grading scale, and the patients' overall satisfaction was evaluated using a 10-point visual analogue scale. Results Two months after the last treatment, mean improvement scores, assessed by physicians, were significantly higher for those treated with half-body fractional CO 2 laser therapy followed by NB-UVB phototherapy, compared with those treated with NB-UVB alone (P = 0·034). In addition, according to subjective assessment, the half-body laser treatment followed by NB-UVB showed significantly higher improvements compared with NB-UVB treatment alone (P = 0·023). Noticeable adverse events, such as infection, scarring and Koebner phenomenon, were not found in any patient. Conclusions This study suggests that fractional CO 2 laser therapy followed by NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of refractory vitiligo.",
author = "J. Shin and Lee, {J. S.} and Hann, {S. K.} and SangHo Oh",
year = "2012",
month = "3",
day = "1",
doi = "10.1111/j.1365-2133.2011.10723.x",
language = "English",
volume = "166",
pages = "658--661",
journal = "British Journal of Dermatology",
issn = "0007-0963",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Combination treatment by 10 600 nm ablative fractional carbon dioxide laser and narrowband ultraviolet B in refractory nonsegmental vitiligo

T2 - A prospective, randomized half-body comparative study

AU - Shin, J.

AU - Lee, J. S.

AU - Hann, S. K.

AU - Oh, SangHo

PY - 2012/3/1

Y1 - 2012/3/1

N2 - Background Vitiligo is a common acquired depigmentation disorder caused by the loss of melanocytes. Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed. Objectives To investigate the effects of fractional carbon dioxide (CO 2) laser therapy followed by systemic narrowband ultraviolet B (NB-UVB) phototherapy on nonsegmental vitiligo (NSV) as a prospective and randomized left-right comparative study. Methods Ten patients with NSV who presented symmetrical vitiligo lesions with no further improvement despite more than 1 year of conventional treatment were enrolled. Two sessions of half-body fractional CO 2 laser therapy were performed at a 2-month interval. NB-UVB phototherapy was then administered to the entire body 5 days after each fractional laser treatment twice a week, increasing the dose incrementally by 15% at each session. Objective clinical assessments were made by two blinded dermatologists using a quartile grading scale, and the patients' overall satisfaction was evaluated using a 10-point visual analogue scale. Results Two months after the last treatment, mean improvement scores, assessed by physicians, were significantly higher for those treated with half-body fractional CO 2 laser therapy followed by NB-UVB phototherapy, compared with those treated with NB-UVB alone (P = 0·034). In addition, according to subjective assessment, the half-body laser treatment followed by NB-UVB showed significantly higher improvements compared with NB-UVB treatment alone (P = 0·023). Noticeable adverse events, such as infection, scarring and Koebner phenomenon, were not found in any patient. Conclusions This study suggests that fractional CO 2 laser therapy followed by NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of refractory vitiligo.

AB - Background Vitiligo is a common acquired depigmentation disorder caused by the loss of melanocytes. Despite the numerous treatment modalities available for vitiligo, responses to treatment are still unsatisfactory. For this reason, new treatment modalities and approaches are needed. Objectives To investigate the effects of fractional carbon dioxide (CO 2) laser therapy followed by systemic narrowband ultraviolet B (NB-UVB) phototherapy on nonsegmental vitiligo (NSV) as a prospective and randomized left-right comparative study. Methods Ten patients with NSV who presented symmetrical vitiligo lesions with no further improvement despite more than 1 year of conventional treatment were enrolled. Two sessions of half-body fractional CO 2 laser therapy were performed at a 2-month interval. NB-UVB phototherapy was then administered to the entire body 5 days after each fractional laser treatment twice a week, increasing the dose incrementally by 15% at each session. Objective clinical assessments were made by two blinded dermatologists using a quartile grading scale, and the patients' overall satisfaction was evaluated using a 10-point visual analogue scale. Results Two months after the last treatment, mean improvement scores, assessed by physicians, were significantly higher for those treated with half-body fractional CO 2 laser therapy followed by NB-UVB phototherapy, compared with those treated with NB-UVB alone (P = 0·034). In addition, according to subjective assessment, the half-body laser treatment followed by NB-UVB showed significantly higher improvements compared with NB-UVB treatment alone (P = 0·023). Noticeable adverse events, such as infection, scarring and Koebner phenomenon, were not found in any patient. Conclusions This study suggests that fractional CO 2 laser therapy followed by NB-UVB phototherapy could be used effectively and safely as an alternative modality for the treatment of refractory vitiligo.

UR - http://www.scopus.com/inward/record.url?scp=84862803696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862803696&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2133.2011.10723.x

DO - 10.1111/j.1365-2133.2011.10723.x

M3 - Article

C2 - 22050270

AN - SCOPUS:84862803696

VL - 166

SP - 658

EP - 661

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

IS - 3

ER -