Summary Objective The aim of this study was to evaluate the efficacy and safety of home and outpatient narrowband ultraviolet B light (NB‐UVB) for the treatment of non‐segmental vitiligo. Methods A total of 94 patients with non‐segmental vitiligo were enrolled. Forty‐eight patients were treated with home NB‐UVB, and the other 46 patients were treated with outpatient NB‐UVB over a period of 6 months. The efficacy, patient quality of life, and adverse events were assessed at month 3 and month 6 after treatment. Results There was no significant difference in repigmentation and VASI‐reverse (VR) rates between outpatient NB‐UVB and home NB‐UVB groups. VR was higher in outpatient NB‐UVB group at month 3, and similar at month 6. For long‐standing vitiligo, VR was higher in the outpatient NB‐UVB group compared with home NB‐UVB group after 6 months of treatment. In recent vitiligo, the VR was similar between the two groups. Additionally, vitiligo‐specific health‐related quality‐of‐life instrument (VitiQoL) score was similar, and the adverse effects were minimal among the two groups. Conclusions The efficacy and safety of home NB‐UVB and outpatient NB‐UVB phototherapy for non‐segmental vitiligo were comparable. According to our results, those with long‐standing vitiligo may be recommended to receive outpatient NB‐UVB phototherapy.
This study aimed to evaluate the effect of IPL treatment on Asian skin by reflectance confocal microscopy (RCM) analysis. Ten Asian female volunteers (39~54 years old, Fitzpatrick skin type III~IV) received five monthly IPL treatments. RCM skin images were evaluated, and several skin physiological parameters including thickness of stratum corneum, minimal thickness of epidermis, thickness of basal layer, density of dermal papillae, and mean diameter of papillae capillaries were measured both at baseline and 1 month after the last treatment. Transepidermal water loss (TEWL) was evaluated, as well. Thickness of stratum corneum was 4.80 ± 1.48 μm before IPL treatment and 5.50 ± 1.35 μm after treatment (p = 0.322). Both minimal thickness of epidermis and thickness of basal layer were significantly increased (p = 0.002 and 0.018, respectively) after IPL treatment. Dermal papillae density was significantly increased (p = 0.035), whereas mean capillary diameter was reduced significantly (p = 0.035). TEWL was slightly increased after treatment, while the difference was not significant on either T-zone or U-zone (p = 0.085 on T-zone and p = 0.114 on U-zone). RCM imaging is a feasible method to evaluate the effect of IPL effect on human skin. Moreover, IPL treatment serves to be highly safe in skin rejuvenation.
Background Postinflammatory hyperpigmentation (PIH) reflects a dynamic process from primary injury and cutaneous inflammation to subsequent melanogenesis and hyperpigmentation, of which pathogenesis remains unclear, hindering the development of targeted therapies. Aims To observe the dynamic development of PIH; determine the starting point and peak point of the inflammatory phase and pigmentary phase; and clarify the timing of anti‐inflammatory and anti‐pigmentary treatment. Methods Thirty healthy volunteers with Fitzpatrick skin types III‐IV were enrolled and underwent suction blisters. The noninvasive evaluation of inflammation and hyperpigmentation on suction blister sites were performed via spectrophotometry (CM2600d and SIAscope) and RCM for the following 24 weeks. Results We successfully observed suction blister‐induced PIH lasting over 24 weeks. The inflammatory phase started soon after the procedure and lasted for 8‐12 weeks, manifested by significantly elevated a* values and erythema index detected by spectrophotometry, as well as inflammatory infiltration and angiogenesis shown in RCM images. Meanwhile, melanogenesis was accelerated after week 3 and reached peak on week 8, manifested by significantly accumulated melanin granules and bright pigment rings in different depths under RCM, which was in parallel with elevated melanin index. The darkening skin tone in PIH actually presented a mixture of inflammatory erythema, angiogenesis, and hyperpigmentation. The inflammation and pigmentation phases of PIH were not sequential but partially overlap. Conclusion The duration of suction blister‐induced PIH is more than 24 weeks. The inflammatory phase partially overlaps with the pigmentary phase, and those drugs with anti‐inflammatory and anti‐pigmentary dual effects are potential choices.
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