Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (A randomized clin
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ORIGINAL ARTICLE
Fractional CO2 laser, platelet rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (A randomized clinical trial) Ahmed Abdelfattah Afify 1
&
Nehal Mohamed Zuelfakkar 1 & Mohamed Abdullah Eshafi 2
Received: 29 May 2020 / Accepted: 13 November 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Vitiligo is a chronic acquired disease. Various therapeutic strategies are available but with variable degrees of success. Fractional CO2 laser is claimed to be effective in the treatment of refractory non-segmental vitiligo. Platelet-rich plasma may help in stimulation of the proliferation of melanocytes and repigmentation within vitiliginous patches.Our aim was to evaluate and compare the efficacy and safety of fractional CO2 laser, PRP, and NB-UVB either alone or in combination in the treatment of vitiligo. This self-controlled randomized clinical trial included 20 patients with at least 6 patches of vitiligo (VIDA score 1 and 0). Each patch was randomly assigned to receive either, fractional CO2 laser, PRP, combined fractional CO2 with PRP, combined fractional CO2 with NB-UVB, combined fractional CO2 with PRP and NB-UVB or left as a control. There was a statistically significant improvement in all treatment groups on comparing the surface area of vitiligo patches before and after treatment. However on comparing the percentage of reduction in surface area in different treatment groups, there was no statistically significant difference (P = 0.122). Fr: CO2 laser and PRP may be adjuvant therapeutic options to NB-UVB especially in the treatment of refractory cases of non-segmental vitiligo. Keywords Fractional . Laser . Platelet . Rich . Plasma . Vitiligo
Introduction Vitiligo is a chronic acquired disease that has an unpredictable clinical course, characterized by the appearance of achromic or hypochromic macules and patches on the skin and mucous membranes [1]. There are a few major hypotheses for the pathogenesis of vitiligo which include the genetic, neural, autoimmune, biochemical, and melanocytorrhagy theories [2]. The mode of re-pigmentation in vitiligo involves reactivation of the melanocytes located in the outer root sheath of the hair follicles or from the contiguous pigmented skin [3]. Name of the institution(s) at which the research was conducted: Dermatology outpatient clinic of Ain-Shams University Hospitals * Ahmed Abdelfattah Afify [email protected] 1
Dermatology, Venereology and Andrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2
Tripoli University-Libya, Tripoli, Libya
Various therapeutic strategies for vitiligo are available including nonsurgical and surgical methods but with variable degrees of success [4]. Narrow band ultraviolet B (NB-UVB) phototherapy which utilizes UV radiation in the specific wave length range of 311– 312 nm is considered to be a very important modality in vitiligo treatment since it is use in 1997 [5]. Fractional CO2 (Fr:CO2) laser is proposed to be effective in the treatme
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