Comparative efficacy between localized 308‐nm excimer light and targeted 311‐nm narrowband ultraviolet B phototherapy in vitiligo: A randomized, single‐blind comparison study

Abstract

Background There are limited data to compare efficacy between recent 308‐nm excimer and conventional 311‐nm narrowband ultraviolet B (NB‐UVB) light in the treatment of vitiligo. Objective To compare efficacy between 308‐nm excimer light and 311‐nm NB‐UVB in patients with symmetrical vitiligo lesions. Methods Thirty‐six symmetrically paired vitiligo lesions on the same anatomical area were enrolled. One side of the symmetrical lesions was treated with localized 308‐nm excimer light, and the opposite side was treated with targeted 311‐nm NB‐UVB assigned randomly by computer. All lesions were treated with the same protocol, for 48 sessions. Repigmentation was evaluated using Vitiligo Area Scoring Index (VASI) and grading the repigmentation was carried out with three independent investigators. Results Thirty‐six symmetrically vitiligo lesions were randomly treated, one side with 308‐nm excimer light and the opposite side with 311‐nm NB‐UVB. After 48 sessions, a significantly lower VASI score and a higher grade of repigmentation were observed in 308‐nm excimer light–treated side (P < .001). Nine lesions (25%) treated with 308‐nm excimer light and only five lesions (13.89%) treated with 311‐nm NB‐UVB achieved excellent repigmentation. The 308‐nm excimer light and 311‐nm NB‐UVB–treated sides rapidly obtained 25% repigmentation within a mean of 19.42 sessions and 26.25 sessions, respectively (P = .002). There was no significant difference in mean cumulative UV dosage (P = .065). Side effect as phototoxicity was similar in both sides (P = .08). Conclusion Localized 308‐nm excimer light appears to be more effective and also more rapidly induces repigmentation than targeted 311‐nm NB‐UVB for treatment of vitiligo.

Comparison between 308‐nm excimer light alone versus 308‐nm excimer light and platelet‐rich plasma in the treatment for localized vitiligo

“…In a recent meta‐analysis, quantitative synthesis of the data from these 2 studies suggested that no significant difference was observed between the combination (PRP +NB‐UVB) and monotherapy (NB‐UVB) groups regarding the clinical improvement 20 . Since the NB‐UVB emission spectrum is close to that of MEL and that both modalities act in vitiligo through the same mechanisms, 21 these findings could also be applied to the combination of PRP and MEL.…”

Excimer Laser 308 nm

“…Hypopigmentation on the face and neck responds more quickly than the extremities (Mehraban & Feily, 2014). Vitiligo lesions on the elbows and knees are less responsive to treatment (Poolsuwan et al, 2021).…”

“…Phototherapy is a first-line treatment for active nonsegmental vitiligo (Ganzetti et al, 2017). In a study of 36 patients who underwent side-by-side treatment of symmetrical vitiligo lesions, there is a significant reduction in vitiligo severity and higher repigmentation noted on the 308-nm excimer-laser-treated side compared with the 311-nm narrowband UVB (NB-UVB) side (Poolsuwan et al, 2021). Higher treatment efficiency is noted with combination treatment of the 308-nm excimer laser and topical steroids, but limited to no increase in efficacy is noted with topical Vitamin D (Taieb et al, 2013).…”

Comparison of NB‐UVB combination therapy regimens for vitiligo: A systematic review and network meta‐analysis

“…MEL emits monochromatic wavelengths, providing higher penetration depth and selectively focusing treatment on white spots, which is less likely to cause hyperpigmentation of the surrounding skin. A randomized single-blind controlled study showed that 308 nm excimer phototherapy induced faster pigmentation than 311 nm NB-UVB, 8 but NB-UVB was preferred for extensive (>5% of body surface area) or progressive vitiligo. 9,10 The therapeutic mechanism of NB-UVB in vitiligo involves a variety array of mechanisms.…”