Funding sources This study was supported by the ‘Association Française du Vitiligo’ and was promoted by the CHU of Nice, France.
Effect of a preceding laser dermabrasion on the outcome of combined therapy with narrowband ultraviolet B and potent topical steroids for treating nonsegmental vitiligo in resistant localizations
Article first published online: 17 NOV 2011
© 2011 The Authors. BJD © 2011 British Association of Dermatologists
British Journal of Dermatology
Volume 166, Issue 1, pages 208–211, January 2012
How to Cite
Bayoumi, W., Fontas, E., Sillard, L., Le Duff, F., Ortonne, J.-P., Bahadoran, P., Lacour, J.-P. and Passeron, T. (2012), Effect of a preceding laser dermabrasion on the outcome of combined therapy with narrowband ultraviolet B and potent topical steroids for treating nonsegmental vitiligo in resistant localizations. British Journal of Dermatology, 166: 208–211. doi: 10.1111/j.1365-2133.2011.10564.x
Conflicts of interest None declared.
- Issue published online: 27 DEC 2011
- Article first published online: 17 NOV 2011
- Accepted manuscript online: 8 AUG 2011 11:45PM EST
- Accepted for publication 29 July 2011
Background The treatment of vitiligo remains unsatisfactory.
Objectives To assess in patients with vitiligo the effect of a laser dermabrasion in addition to the association of topical steroids and ultraviolet (UV) B in difficult-to-treat areas.
Methods This was a single-centre prospective randomized trial including patients with nonsegmental vitiligo who had at least two symmetrical lesions located on bony prominences and/or extremities. An erbium laser-assisted dermabrasion was first performed on one side (randomly assigned). After 48 h, hydrocortisone 17-butyrate cream applied daily for three periods of 3 weeks followed by a 1-week steroid-free interval and narrowband UVB treatment was performed on both sides twice weekly for 12 weeks. The evaluation was performed on standardized pictures by two physicians blinded to the type of treatment received. The criterion of success was a repigmentation of at least 50%, 1 month after the end of the treatment.
Results Eighteen patients were included (24 paired lesions treated). Two patients dropped out for personal reasons. Almost 50% of lesions achieved at least 50% repigmentation in the dermabrasion side while only 4·2% did so with topical steroids and UVB alone (P < 10−4). Side-effects were delayed healing, pain and two hypertrophic scars. The tolerance and patient satisfaction were 4·2 and 4/10 for the laser-treated side and 8·4 and 3/10 in the UVB+ steroids alone group, respectively.
Conclusions Laser dermabrasion significantly improves the repigmentation rate in vitiligo lesions. Despite a high rate of repigmentation in such difficult-to-treat areas the high rate of side-effects and the poor tolerance strongly limit its use in current practice.