<p>Effect of Topical 5-Fluorouracil Alone versus Its Combination with Erbium:YAG (2940 nm) Laser in Treatment of Vitiligo</p>

Abstract

To compare the efficacy of topical 5-FU as monotherapy to combined therapy of topical 5-FU and Er:YAG (2940 nm) laser in the treatment of non-segmental vitiligo (NSV). Methods: This is a prospective randomized comparative study. Thirty patients diagnosed with NSV were recruited from the dermatology outpatient clinics of the Medical Research Centre of Excellence, the National Research Centre and the National Institute of Laser Enhanced Sciences. Our study group was divided into two subgroups, Group 1 was subjected to ablative Er:YAG and 5-FU cream and Group 2 applied topical 5-FU cream. Three treatment sessions were repeated every 4 to 6 weeks and patients were followed up to 9 months. Repigmentation was assessed by digital photography and subsequent computer based image analysis. Results: Repigmentation of Group 1 patients ranged from 0 to 70% (mean 12±7%) whilst in Group 2 this ranged from 0 to 5% (mean 1.4±0.8%). In Group 1 repigmentation was mild in 22/30 (73.3%) and moderate to severe in 3/30 (10%) starting after 3 months and persisted or increased during the period of follow up to 9 months. Groups 1 and 2 were subdivided into A and B, vitiligo involving non-resistant and resistant areas respectively. Group 1A showed more repigmentation (mean 13.8±8.5%) than Group 1B (mean 9.8±4.5%) and Group 2A showed more repigmentation (mean 1.5±1%) than Group 2B (mean 1.3±0.5%). Conclusion: The combination of Er:YAG with 5-FU is safe and effective in treating and improving outcome in vitiligo especially of non-resistant areas. Computer based image analysis of vitiliginous lesions and assessing post-therapy response is an easy, quick, and reliable method.

Clinical evaluation of the efficacy of trichloroacetic acid 70% after microneedling vs intradermal injection of 5‐fluorouracil in the treatment of nonsegmental vitiligo; A prospective comparative study

“…Also, the response to 5‐FU in our study was close to its combination with Er:YAG laser and NB‐UVB which has been studied by Anbar et al 13 who reported 43.8% marked response with topical 5‐FU. Abdelwahab et al 14 treated vitiligo with Er:YAG followed by topical 5‐FU cream and showed mild (<25%) repigmentation in 73.3% and moderate (50%‐75%) repigmentation in 10%. Anber and Abdeleahab used expensive laser technique that was applied on relatively smaller areas of vitiligo.…”

Updates and new medical treatments for vitiligo (Review)

“…The observation of hyperpigmentation following therapy with this drug led to its use in vitiligo (48). The mechanisms of repigmentation of 5-FU may include stimulation of follicular melanocytes with migration during epithelization and by increasing the number of melanosomes in keratinocytes (49,50). The efficacy of monotherapy with 5-FU has been reported by Tsuji-Takuo and Hamada (48).…”

“…Several studies have combined laser therapy with topical 5-FU (49,51,52). Abdelwahab et al (49) performed a study to assess the effect of 5-FU in monotherapy compared with its combination with ablative erbium: YAG (2,940 nm) laser in non-segmental vitiligo. Erbium: YAG laser was applied using the surgical handpiece with a spot size of 4 mm and a fluence of 60 J/cm 2 .…”

A single blind active controlled study to compare the efficacy of microneedling and microneedling with 5-flurouracil in treatment of stable vitiligo

“…Z udziału w badaniu wyłączono pacjentów z bielactwem w obrę-releases potassium and proteins inside the epidermal cells, hence reducing electric potential and increasing the potential difference between interior and exterior of the cell which triggers fibroblast migration to the injury site and helps in collagen remodeling [3]. Microneedling also acts as a tool for transdermal delivery of drugs as they create micropores in the epidermis, which helps improve the skin permeability to various therapeutic agents [11].…”

“…Mikronakłuwanie skóry jest także techniką stosowaną przy przezskórnym podawaniu leków. Powoduje powstanie w skórze mikroporów, które umożliwiają lepsze przenikanie przez skórę różnych środków terapeutycznych [11].…”