The efficacy of ablation‐based combination therapy for vitiligo: A systematic review and meta‐analysis

Abstract

SummaryBackground and objectivesThis study aimed to compare the efficacy of vitiligo treatments with and without ablation therapy.Patients and methodsWe conducted a systematic review and meta‐analysis of literature published before September 15, 2017. Comparative studies of vitiligo patients treated with and without ablation therapy were included. The primary outcome was ≥ 50 % repigmentation. Secondary outcomes were ≥ 75 % repigmentation and patient scores on a subjective visual analogue scale.ResultsFifteen studies with a total of 401 participants were included. The ablation‐based combination therapy group had significantly superior results to the control group (odds ratio [OR] for ≥ 50 % repigmentation: 10.490, 95 % confidence interval [CI]: 4.632–23.757; OR for ≥ 75 % repigmentation: 5.812, 95 % CI: 2.194–15.393). Patients receiving ablation‐based combination therapy were significantly more satisfied with the efficacy than the control group (standardized mean difference: 1.073, 95 % CI: 0.528–1.619). Subgroup analysis showed that the erbium laser group, CO2 laser group and fractional CO2 laser group achieved significantly better repigmentation than the control groups.ConclusionsAccording to objective and subjective evaluations, treatments for vitiligo are more effective when combined with ablation therapy than when used alone.

Fractional versus full ablative CO2 laser in recipient site of non‐cultured melanocytes and keratinocyte transplantation in treatment of vitiligo

“…This favorable environment for melanocyte stimulation is created by melanogenic cytokines and growth factors which are secreted during the inflammation and wound healing phase after ablation treatments. 2 Also laser ablation covers a thin rim of the perilesional skin and induces the migration of melanocytes from the adjacent normal skin to the vitiliginous areas. 21 Furthermore, the fractional ablation laser may facilitate the delivery of topical agents through laser-created channels into the surrounding dermis.…”

Die Verwendung von Trichloressigsäure als Depigmentierungstherapie bei Vitiligo universalis

“…Die Weißfleckenkrankheit (Vitiligo) ist eine erworbene Depigmentierungsstörung unbekannter Ätiologie. Es gibt verschiedene Hypothesen über ihre Entstehung; so werden ein autoimmuner, ein neurohumoraler oder ein autozytotoxischer Hintergrund vermutet [1, 2]…”

Lasers in the Treatment of Vitiligo

“…Koebner's phenomenon defined as the development of isomorphic lesions at traumatized uninvolved skin due to that fractional modalities to be concluded follicular hyperpigmentation as a different addition for pathogenesis. King et al published a metanalysis, they determined ablation modalities (ER-YAG or fractional CO 2 laser) manage faster and effective repigmentation than the traditional methods that have explained via four different such as more penetration, skin remodeling, melanocyte migration and cytokine secretion [30]. Despite of that Koebner phenomenon has not seen in stable lesions so that individual remedy should be chosen.…”