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Study the effect of erbium:YAG laser plus topical 5‐flurouracil in stable vitiligo resistant to NB‐UVB phototherapy
Author(s) -
Doghaim Noha Nabil,
ElTatawy Rania Ahmed,
Ismail Mayada A.,
Ali Dareen Abdelaziz Mohammed,
El Attar Yasmina Ahmed
Publication year - 2020
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.13134
Subject(s) - vitiligo , medicine , dermabrasion , dermatology , ablation , er:yag laser , side effect (computer science) , hypopigmentation , adverse effect , refractory (planetary science) , outer root sheath , surgery , laser , hair follicle , materials science , physics , computer science , optics , composite material , programming language
Background NB‐UVB phototherapy is still an effective treatment in vitiligo but requires more than 1 year for its completion. Topical 5‐flurouracil could improve the proliferation and migration of melanocytes. Laser‐assisted dermabrasion results in stimulation of the inactive melanocytes present at the outer root sheath of the lower portion of the hair follicle, which migrates upward until they reach the surface of the skin. Objective To evaluate the effect of Er:YAG laser skin ablation followed by topical 5‐flurouracil on the outcome of NB‐UVB phototherapy as a short term technique in resistant and stable vitiligo. Methods The current study included 40 patients suffering from bilateral stable vitiligo resistant to NB‐UVB. For each patient, one side of the body subjected to 4 months NB‐UVB sessions (control side). While the other side of the body subjected to one session of Er:YAG laser ablation combined with topical 5% 5‐flurouracil application under occlusion followed by NB‐UVB sessions for 4 months after complete re‐epithelization. Outcomes were evaluated objectively based on standard digital photographs, histopathological examination, patient satisfaction, and adverse effects. Results There was a statistically significant improvement in the repigmentation in laser side compared with control side. Histopathological examination revealed expression of prominent melanin pigmentation, with marked expression for Melan‐A in laser side, whereas these findings were negative in control side. Conclusion Er:YAG laser ablation, followed by 5FU application before NB‐UVB phototherapy for vitiligo, is a safe and tolerable technique that improves the outcome of short‐term NB‐UVB therapy and is expected to increase patient compliance.