Treatment protocols and efficacy of combined laser with medical treatment modalities in vitiligo

Mohammadi, Saman; Amiri, Rezvan; Khalili, Maryam; Iranmanesh, Behzad; Aflatoonian, Mahin

doi:10.1111/jocd.14602

Cited by 9 publications

(18 citation statements)

References 39 publications

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“…Another recent approach involves using lasers (excimer, CO 2 , Er:YAG, and non‐ablative resurfacing laser), even combined with topical treatments 5,6 …”

Section: Introductionmentioning

confidence: 99%

Blue light‐emitting diodes for the treatment of localized vitiligo: A retrospective study

Lodi

Nisticò

et al. 2022

J of Cosmetic Dermatology

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Vitiligo is a depigmenting skin condition that affects 0.5%-2% of the global population of all ethnic groups and skin types, with no distinctions. The condition is defined by the selective loss of melanocytes, resulting in non-scaly, chalky-white macules. Vitiligo is considered a cosmetic issue, even though its symptoms can be psychologically distressing and significantly impact everyday life.It is now firmly recognized as an autoimmune disease, with hereditary and environmental components, as well as metabolic issues, oxidative stress, and cell detachment. 1 The diagnosis of vitiligo is clinical and usually straightforward, based on the presence of acquired, amelanotic macules with clear edges in a typical distribution: periorificial, lips and distal extremity tips, penis, segmental, and frictional areas. Generally, laboratory tests are not required, but histological samples show a total loss of melanin pigment and a lack of melanocytes. Lymphocytes may occasionally be seen at the advancing edge of the lesions. 2 Phototherapy (ultraviolet A and B), topical and systemic immunosuppressants (corticosteroids, calcineurin inhibitors), may assist in slowing the progression of vitiligo, stabilize depigmented lesions, and stimulate repigmentation. 3,4 As most therapies are time-demanding and require long-term follow-up, management may need an individualized therapeutic strategy in which patients should always be consulted.Cosmetic camouflage advice from a cosmetician or a professional nurse should be supplied to people with vitiligo that affects exposed regions. 1

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“…Another recent approach involves using lasers (excimer, CO 2 , Er:YAG, and non‐ablative resurfacing laser), even combined with topical treatments 5,6 …”

Section: Introductionmentioning

confidence: 99%

Blue light‐emitting diodes for the treatment of localized vitiligo: A retrospective study

Lodi

Nisticò

et al. 2022

J of Cosmetic Dermatology

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“…Besides systemic medications, surgical grafting and discoloration, topical medications and phototherapy are the first-line treatment of vitiligo. 6,7 The two most common topical drugs are glucocorticoid and calcineurin inhibitors. The therapeutic effect of the topical calcineurin inhibitor (TCI) is equal to the potent topical steroid, 8 but TCI does not have any glucocorticoid adverse reactions such as telangiectasia, hairy and skin atrophy.…”

Section: Introductionmentioning

confidence: 99%

“…Phototherapy combined with other treatments can provide higher efficiency, quicker onset of action and better adherence to treatment. 6 Since Kawalek et al 14 first reported the synergistic effect of topical tacrolimus combined with 308-nm EL in 2004, many studies have demonstrated that 308-nm EL combined with TCI is more efficient than 308-nm EL monotherapy in the treatment of vitiligo. [15][16][17][18][19][20] However, there is no literature illuminating combined therapy is better for the special vitiligo region like the periocular skin.…”

Section: Introductionmentioning

confidence: 99%

“…Besides systemic medications, surgical grafting and discoloration, topical medications and phototherapy are the first‐line treatment of vitiligo 6,7 . The two most common topical drugs are glucocorticoid and calcineurin inhibitors.…”

Section: Introductionmentioning

confidence: 99%

“…From psoralen with UVA (PUVA) to narrowband UVB (NB‐UVB) in 1997, then 308‐nm excimer laser (308‐nm EL) in 2001, phototherapy for vitiligo has become safer, more efficient and more practical. Phototherapy combined with other treatments can provide higher efficiency, quicker onset of action and better adherence to treatment 6 . Since Kawalek et al 14 first reported the synergistic effect of topical tacrolimus combined with 308‐nm EL in 2004, many studies have demonstrated that 308‐nm EL combined with TCI is more efficient than 308‐nm EL monotherapy in the treatment of vitiligo 15–20 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the efficacy and safety of 308‐nm excimer laser as monotherapy and combination therapy with topical tacrolimus in the treatment of periocular vitiligo

Zhou

Chen

Jin

et al. 2022

Dermatologic Therapy

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Vitiligo is an acquired depigmenting disorder in which destruction of skin melanocytes. In recent years, 308‐nm excimer laser (308‐nm EL) and topical tacrolimus have been extensively used to treat vitiligo. This study aimed to investigate the effectiveness and safety of combined treatment of 308‐nm EL and topical tacrolimus for treating periocular vitiligo compared to 308‐nm EL monotherapy. This study is a retrospective observational study, involving 58 Chinese patients of periocular vitiligo, divided into two groups: the control group (28 patients) treated with 308‐nm EL; and the experimental group (30 patients) treated with 308‐nm EL and topical tacrolimus 0.1% ointment. Repigmentation was assessed at four grades. In the control group, there were four patients (14%) with poor repigmentation, eleven patients (39%) with moderate repigmentation, ten patients (36%) with good repigmentation, three patients (11%) with excellent repigmentation. In the experimental group, two patients (7%) experienced poor repigmentation, six patients (20%) experienced moderate repigmentation, fifteen patients (50%) experienced good repigmentation, seven patients (23%) experienced excellent repigmentation. The experimental group efficacy rate (good and excellent repigmentation) was 73.3%, higher than 46.4% for the control group (p = 0.037). Our findings suggest that both treatments are safe and the combination of tacrolimus and 308‐nm EL is more effective than 308‐nm EL alone for periocular vitiligo.

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Comparative study between efficacy of Excimer light with topical Tacrolimus 0.1% versus excimer light with topical Bimatoprost 0.01% in treatment of facial Vitiligo

Zaky,

Atallah,

El Abasy

et al. 2024

Arch Dermatol Res

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Loss and absence of melanocytes due to a number of factors is responsible for vitiligo; known to be the commonest disorder of pigmentation. The aim of the current work was to compare the efficacy and safety of excimer light with topical tacrolimus ointment 0.1% versus excimer light with topical bimatoprost gel 0.01% in treatment of facial vitiligo. The study was carried out on 48 patients presented with facial vitiligo. The patients were divided randomly using sealed envelope method into two groups (24 patients each). Group 1 were treated with excimer light plus topical tacrolimus ointment 0.1% and group 2 treated with excimer light plus topical bimatoprost gel 0.01%. Clinical improvement based on the quartile grading scale at the end of treatment did not show any statistically significant difference between groups. The majority of subjects in both groups experienced good to excellent improvement. Only 20.9% of patients in group 1 and 33.3% of subjects in group 2 achieved less than 50% repigmentation (p = 0.889). Our study demonstrated that 0.01% topical bimatoprost gel in combination with excimer light is considered safe and effective as treatment of nonsegmental facial vitiligo with comparable results to 0.1% tacrolimus.

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Treatment protocols and efficacy of combined laser with medical treatment modalities in vitiligo

Cited by 9 publications

References 39 publications

Blue light‐emitting diodes for the treatment of localized vitiligo: A retrospective study

Blue light‐emitting diodes for the treatment of localized vitiligo: A retrospective study

Comparison of the efficacy and safety of 308‐nm excimer laser as monotherapy and combination therapy with topical tacrolimus in the treatment of periocular vitiligo

Comparative study between efficacy of Excimer light with topical Tacrolimus 0.1% versus excimer light with topical Bimatoprost 0.01% in treatment of facial Vitiligo

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