Efficacy of 308 nm Excimer laser in the treatment of vitiligo: A Retrospective study

Harish Muddanahalli Rajegowda, Shashi Kumar Basavapura Madegowda, Deepadarshan Kalegowda, Dr. Thabassum A

Abstract


Background Vitiligo is a chronic, polygenic dyschromia that presents with multiple depigmented macules & patches. Widespread prejudices, ignorance, taboos, lack of scientific appraisal and confusion of vitiligo with leprosy all makes it an immense psychological stress.

 

Objectives To determine the efficacy of 308 nm excimer laser in vitiligo.

 

Materials and Methods Record based retrospective study of 40 patients with localized vitiligo who were treated with 308nm excimer laser were included. Twice weekly 308nm excimer laser (Eximal elite, GSD®) was given to 40 patients with 120 vitiligo lesions till complete resolution or till maximum 30 sessions whichever occurred earlier. Initial doses used were of 200-250mJ/cm2 with increments of 50mJ/cm2 every session. Repigmentation was monitored by serial photographs and graded as excellent (≥75% repigmentation), good (50−74% repigmentation) and poor (<50% repigmentation) at the end of study period. The extent of repigmentation achieved was correlated with site of the lesion.

 

Results A total of 40 patients each with 1-5 vitiligo lesions between age group of 6-69 years were included. Females outnumbered males in the ratio of 1.5:1. Majority of the patients belonged to <15 years age group. Seven patients had segmental vitiligo while 33 were diagnosed as non segmental vitiligo. The most common site affected was lower limbs followed by trunk. Out of 120 lesions treated, 32 lesions (26.6%) showed excellent response. Among rest of 88 lesions, 39 lesions (32.5%) failed to show satisfactory response to treatment while 40.8% showed good response. Lesions on trunk responded best to treatment followed by lower limb. Eighteen (45%) patients aged less than 18 years showed excellent to good response.

 

Conclusion 308nm excimer laser is as promising therapy in treatment of localized vitiligo especially in children with rapid onset of repigmentation as early as 3 sessions of treatment.

 

Limitations The study is limited by its retrospective nature and small sample size.

 


Keywords


308nm excimer laser, vitiligo, treatment

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References


Ortonne JP, Passeron T. Vitiligo and Other Disorders of Hypopigmentation. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Bolognia: Dermatology. 4th ed. Elsevier Limited; 2018; 66: 1087-1096.

Ongenae K, Beelaert L, van Geel N, Naeyaert JM. Psychosocial effects of vitiligo. J Eur Acad Dermatol Venereol 2006; 20: 1-8.

Kent G, al-Abadie M. Factors affecting responses on Dermatology Life Quality Index items among vitiligo sufferers. Clin Exp Dermatol 1996; 21: 330-3.

Majid I, Imran S. Targeted ultraviolet B phototherapy in vitiligo: A comparison between once-weekly and twice-weekly treatment regimens. Indian J Dermatol Venereol Leprol 2015; 81: 600-5.

Mysore V, Shashikumar B M. Targeted phototherapy. Indian J Dermatol Venereol Leprol 2016; 82: 1-6.

Majid I. Efficacy of targeted narrowband ultraviolet B therapy in Vitiligo. Indian J Dermatol 2014; 59: 485-9.

Raghuwanshi AD, Jambhore MW, Vishwanath V, Gopalan V. A retrospective study of the utility of targeted phototherapy in vitiligo. Indian J Dermatol Venereol Leprol 2018; 84: 49-53.

Ezzedine K, Lim HW, Suzuki T, Katayama I, Hamzavi I, Lan CC, et al. Revised classification/nomenclature of vitiligo and related issues: The Vitiligo Global Issues Consensus Conference. Pigment Cell Melanoma Res 2012; 25: E1-13.

Das S, Majumder P, Chakraborty R, Majumdar T, Haldar B, Rao D. Studies on vitiligo I. Epidemiological profile in Calcutta, India. Genet Epidemiol 1985;2: 71-8.

Scherschun L, Kim JJ, Lim HW. Narrow-band ultraviolet B is a useful and well-tolerated treatment for vitiligo. J Am Acad Dermatol 2001; 44: 999-1003.

Njoo MD, Bos JD, Westerhof W. Treatment of generalized vitiligo in children with narrow-band (TL-01) UVB radiation therapy. J Am Acad Dermatol 2000; 42: 245-53.

Hamzavi I, Lui H. Using light in dermatology: An update on lasers, ultraviolet phototherapy, and photodynamic therapy. Dermatol Clin 2005; 23: 199-207.

Choi KH, Park JH, Ro YS. Treatment of Vitiligo with 308-nm xenon-chloride excimer laser: Therapeutic efficacy of different initial doses according to treatment areas. J Dermatol 2004; 31: 284-92.

Cui J, Shen LY, Wang GC. Role of hair follicles in the repigmentation of vitiligo. J Invest Dermatol. 1991; 97(3): 410–416.

Anbar TS, Westerhof W, Abdel-Rahman AT, El-Khayyat MA. Evaluation of the effects of NB-UVB in both segmental and non-segmental vitiligo affecting different body sites. Photodermatol Photoimmunol Photomed. 2006; 22: 157–163.

Asawanonda P, Charoenlap M, Korkij W. Treatment of localized vitiligo with targeted broadband UVB phototherapy: A pilot study. Photodermatol Photoimmunol Photomed 2006; 22: 133-6.

Menchini G, Tsoureli-Nikita E, Hercogova J. Narrow-band UV-B micro-phototherapy: A new treatment for vitiligo. J Eur Acad Dermatol Venereol 2003; 17: 171-7.


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