A randomized comparison of excimer laser versus narrow-band ultraviolet B phototherapy after punch grafting in stable vitiligo patients

被引:51
作者
Homan, M. W. Linthorst [1 ,2 ]
Spuls, Ph I. [2 ]
Nieuweboer-Krobotova, L. [1 ,2 ]
de Korte, J. [2 ]
Sprangers, M. A. G. [3 ]
Bos, J. D. [2 ]
Wolkerstorfer, A. [1 ,2 ]
van der Veen, J. P. W. [1 ,2 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Netherlands Inst Pigment Disorders, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Dermatol, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Med Psychol, NL-1105 AZ Amsterdam, Netherlands
关键词
308; NM; UVB PHOTOTHERAPY; EFFICACY; REPIGMENTATION; LIGHT;
D O I
10.1111/j.1468-3083.2011.04147.x
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background Ultraviolet radiation following punch grafting may stimulate the migration of melanocytes from the grafts into the vitiliginous skin, thereby increasing the rate of repigmentation. We compared the effects of the 308-nm xenon chloride excimer laser (EL) vs. narrow-band ultraviolet B (NB-UVB) after punch grafting in patients with vitiligo. Objectives The aims of this study were to evaluate (i) repigmentation (%); (ii) treatment satisfaction; and (iii) patient preferences for EL vs. NB-UVB therapy after punch grafting in vitiligo. Methods Fourteen patients were treated with the punch-grafting technique on two symmetrical vitiligo patches. Starting 1 week after the punch grafting, the vitiligo patches were treated twice a week during 3 months, with EL on one side and with NB-UVB on the other side. Repigmentation (%) was measured by a digital image analysis system. Patients satisfaction and preference for treatment were also assessed. Results Whereas both treatment modalities induced repigmentation, no statistically significant difference was found in grade of repigmentation after 3 months. With EL, 71.4% lower cumulative dose was reached. Patients were significantly more satisfied with NB-UVB and preferred it over EL. Conclusions The choice between EL and NB-UVB cannot solely be based on repigmentation, but rather on other factors, such as patients preferences. However, given the lower UV dose of EL, we recommend its use in vulnerable populations, such as in small children and patients with sun-damaged skin with a history of long-term UVB treatment.
引用
收藏
页码:690 / 695
页数:6
相关论文
共 26 条
[1]   Treatment of vitiligo with the 308-nm xenon chloride excimer laser [J].
Baltás, E ;
Csoma, Z .
ARCHIVES OF DERMATOLOGY, 2002, 138 (12) :1619-1620
[2]   REPIGMENTATION IN VITILIGO VULGARIS BY AUTOLOGOUS MINIGRAFTING - RESULTS IN 19 PATIENTS [J].
BOERSMA, BR ;
WESTERHOF, W ;
BOS, JD .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1995, 33 (06) :990-995
[3]   Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311-313 nm) in the treatment of vitiligo - a multicentre controlled study [J].
Casacci, M. ;
Thomas, P. ;
Pacifico, A. ;
Bonnevalle, A. ;
Vidolin, A. Paro ;
Leone, G. .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2007, 21 (07) :956-963
[4]   Treatment of vitiligo with 308-nm xenon-chloride excimer laser: Therapeutic efficacy of different initial doses according to treatment areas [J].
Choi, KH ;
Park, JH ;
Ro, YS .
JOURNAL OF DERMATOLOGY, 2004, 31 (04) :284-292
[5]   Narrow band Ultraviolet B 311 nm in the treatment of vitiligo: two right-left comparison studies [J].
El Mofty, M ;
Mostafa, W ;
Esmat, S ;
Youssef, R ;
Azzam, O ;
Hunter, N ;
El Hanafi, G ;
Fawzi, M .
PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE, 2006, 22 (01) :6-11
[6]   Treatment of vitiligo with the 308 nm excimer laser [J].
Esposito, M ;
Soda, R ;
Costanzo, A ;
Chimenti, S .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2004, 29 (02) :133-137
[7]   THE MINIGRAFTING TEST FOR VITILIGO - DETECTION OF STABLE LESIONS FOR MELANOCYTE TRANSPLANTATION [J].
FALABELLA, R ;
ARRUNATEGUI, A ;
BARONA, MI ;
ALZATE, A .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1995, 32 (02) :228-232
[8]   THE VALIDITY AND PRACTICALITY OF SUN-REACTIVE SKIN TYPE-I THROUGH TYPE-VI [J].
FITZPATRICK, TB .
ARCHIVES OF DERMATOLOGY, 1988, 124 (06) :869-871
[9]   The use of the 308-nm excimer laser for the treatment of vitiligo [J].
Hadi, SM ;
Spencer, JM ;
Lebwohl, M .
DERMATOLOGIC SURGERY, 2004, 30 (07) :983-986
[10]   The efficacy of excimer laser (308 nm) for vitiligo at different body sites [J].
Hofer, A ;
Hassan, AS ;
Legat, FJ ;
Kerl, H ;
Wolf, P .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2006, 20 (05) :558-564