Conflicts of interest: None declared.
Effect of one session of ER:YAG laser ablation plus topical 5Fluorouracil on the outcome of short-term NB-UVB phototherapy in the treatment of non-segmental vitiligo: a left–right comparative study
Article first published online: 11 NOV 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Photodermatology, Photoimmunology & Photomedicine
Volume 24, Issue 6, pages 322–329, December 2008
How to Cite
Anbar, T. S., Westerhof, W., Abdel-Rahman, A. T., Ewis, A. A. and El-Khayyat, M. A. (2008), Effect of one session of ER:YAG laser ablation plus topical 5Fluorouracil on the outcome of short-term NB-UVB phototherapy in the treatment of non-segmental vitiligo: a left–right comparative study. Photodermatology, Photoimmunology & Photomedicine, 24: 322–329. doi: 10.1111/j.1600-0781.2008.00385.x
- Issue published online: 11 NOV 2008
- Article first published online: 11 NOV 2008
- Accepted for publication: 6 June 2008
Vol. 25, Issue 1, 61, Article first published online: 7 JAN 2009
- ER:YAG laser;
Background: NB-UVB phototherapy is a very important modality in treating vitiligo but the treatment course usually exceeds 1 year. Skin ablation with mechanical dermabrasion with 5Fluorouracil (5FU) was introduced to treat vitiligo in 1983. This was modified replacing the mechanical dermabrasion by erbium-YAG (ER:YAG) laser ablation and resulted in better prognosis in periungual vitiligo.
Purpose: In the present study, we are exploring the effect of the use of ER:YAG laser skin ablation and application of 5FU on the outcome of short-term NB-UVB therapy for patients with non-segmental vitiligo (NSV).
Methods: This study included 50 adult patients with a total of 65-paired symmetrical NSV lesions in different body parts. One side was treated with ER:YAG laser ablation, followed by 5FU application before simultaneous NB-UVB therapy of both sides for a maximum period of 4 months. The outcome was then evaluated both qualitatively and quantitatively.
Results: The overall response to therapy was better using the combination therapy. Fifty patients (78.1%) experienced a moderate-marked repigmentation response in the combination group compared with 23.4% in the mono-therapy group. The response was significantly higher when using the combination therapy in different body parts (P value is <0.05), except for feet lesions, which were better but not statistically significant (P value=0.15). Tolerable pain during ablation or at sites of 5FU application was reported in all cases. Transient hyperpigmentation occurred in 30% of cases and 3.1% of lesions healed by a transient slate blue color. Half of the treated periungual lesions showed a temporary tiny brownish spot on nail plates and Köebnerization was not detected in any patient.
Conclusion: We concluded that prior use of ER:YAG laser skin 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.