This study demonstrates that adding fractional CO2 laser treatment to NB-UVB phototherapy and topical steroids improves the repigmentation rate of vitiliginous lesions on hands in some patients. This technique may be offered to vitiligo patients who are unresponsive to other treatments.

Facial vitiligo is associated with considerable psychological impact. The management is challenging and requires multidisciplinary treatment. Adding fractional carbon dioxide (CO2) to the conventional treatment has been reported as an effective modality. This study aimed to evaluate the efficacy of combined fractional CO2 laser, targeted ultraviolet B (UVB) phototherapy, and topical steroid on facial vitiligo. A prospective, randomized, split face study was conducted on 14 patients with symmetrical non-segmental facial vitiligo. Ten sessions of fractional CO2 laser was performed on the lesions on one side of face with 2-week interval. Immediately after laser, the lesions on both side of face were treated with 10 sessions of 2-week interval targeted UVB phototherapy and twice daily application of topical 0.05 % clobetasol propionate cream. The patients were followed up for 12 weeks after the last treatment. Clinical improvement was graded by blinded dermatologists and patients using a quartile grading scale. Twelve out of 14 patients completed the study. The degree of improvement was not different between both sides in nine patients. One patient showed more improvement on the combined laser side, and two patients showed inferior results on the combined laser side. Two patients with lesser improvement on the laser-treated side had positive Koebner phenomenon on the non-facial area. The combined treatment with laser, targeted UVB, and topical steroids are not superior to targeted UVB and topical steroids in facial vitiligo. Furthermore, laser may retard the response to the standard treatment in patients with Koebner phenomenon on non-treated areas.

Background:The popularity of laser therapy in acne treatment has been increasing recently due to its safety, effectiveness, and convenience. Both 595-nm pulsed dye laser (PDL) and 1064-nm long-pulsed neodymium:yttrium-aluminum-garnet laser (Nd:YAG) have been successful in treating inflammatory acne lesions. However, clinical data from controlled comparative studies are still lacking.Aims: To compare the clinical efficacy of 1064-nm Nd:YAG with 595-nm PDL for the treatment of acne vulgaris.Methods: Thirty-four participants with mild to moderate facial acne were enrolled and then randomized to receive three, 2-week interval treatments with 1064-nm Nd:YAG on one side of the face and 595-nm PDL on the other side. Clinical assessments including acne lesion counts, acne erythema grading, and erythema index were performed at baseline, 2nd, 4th, and 8th week. Participants' satisfaction, preference, and adverse effects were recorded.Results: As compared with baseline, the significant reduction of mean inflammatory acne lesion counts, acne erythema grading, and erythema index was demonstrated on 595-nm PDL-treated sides and 1064-nm Nd:YAG-treated sides. However, there were no significant differences between both sides. The participants were satisfied with both laser treatments, but the participants preferred 1064-nm Nd:YAG over 595-nm PDL treatment. The adverse effects were less on 1064 nm Nd: YAG-treated sides.Conclusions: 1064-nm Nd:YAG and 595-nm PDL treatments are equally effective in reducing inflammatory acne lesions and acne erythema in mild to moderate facial acne vulgaris.

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