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使用掺铒钇铝石榴石激光联合5-氟尿嘧啶和丙酸氯倍他索治疗白癜风的潜在新疗法。

Potential emerging treatment in vitiligo using Er:YAG in combination with 5FU and clobetasol.

作者信息

Mokhtari Fatemeh, Bostakian Anis, Shahmoradi Zabihollah, Jafari-Koshki Tohid, Iraji Fariba, Faghihi Gita, Hosseini Sayed Mohsen, Bafandeh Behzad

机构信息

Skin Diseases and Leishmaniasis Research Center, Department of Dermatology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

J Cosmet Dermatol. 2018 Apr;17(2):165-170. doi: 10.1111/jocd.12373. Epub 2017 Jul 19.

Abstract

BACKGROUND

Vitiligo is a pigmentary disorder of skin affecting at least 1% of the world population of all races in both sexes. Its importance is mainly due to subsequent social and psychological problems rather than clinical complications. Various treatment choices are available for vitiligo; however, laser-based courses have shown to give more acceptable results.

OBJECTIVE

The aim of this trial was to evaluate the efficacy of Er:YAG laser as a supplementary medicine to topical 5FU and clobetasol in vitiligo patients.

METHODS

Two comparable vitiligo patches from 38 eligible patients were randomized to receive topical 5FU and clobetasol in control group and additional Er:YAG laser in intervention group. Major outcomes of interest were the size of patch and pigmentation score at randomization and 2 and 4 months after therapy.

RESULTS

Final sample included 18 (47%) male patients and age of 35.66±8.04. The performance Er:YAG group was superior in all sites. Reduction in the size of patches was greater in Er:YAG group (p-value=.004). Also, this group showed a higher pigmentation scores in the trial period than control group (p-value<.001).

CONCLUSIONS

Greater reduction in the size and increase in pigmentation score was seen in Er:YAG group especially for short periods after therapy and repeating laser sessions may help improving final outcomes. Er:AYG could help in reducing complications of long-term topical treatments, achieving faster response, and improving patient adherence.

摘要

背景

白癜风是一种皮肤色素紊乱疾病,影响着世界上所有种族、所有性别的至少1%的人口。其重要性主要源于随后出现的社会和心理问题,而非临床并发症。白癜风有多种治疗选择;然而,基于激光的疗程已显示出更可接受的效果。

目的

本试验的目的是评估铒钇铝石榴石激光(Er:YAG激光)作为局部使用5-氟尿嘧啶(5FU)和丙酸氯倍他索的辅助药物对白癜风患者的疗效。

方法

从38名符合条件的患者身上选取两块具有可比性的白癜风斑块,随机分为对照组,接受局部使用5FU和丙酸氯倍他索,干预组在此基础上额外接受Er:YAG激光治疗。主要观察指标为随机分组时、治疗后2个月和4个月时斑块的大小和色素沉着评分。

结果

最终样本包括18名(47%)男性患者,年龄为35.66±8.04。Er:YAG激光治疗组在所有部位的表现均更优。Er:YAG激光治疗组斑块大小的减小更为显著(p值 = 0.004)。此外,在试验期间,该组的色素沉着评分高于对照组(p值<0.001)。

结论

Er:YAG激光治疗组的斑块大小减小更为显著,色素沉着评分增加,尤其是在治疗后的短时间内,重复进行激光治疗可能有助于改善最终疗效。Er:AYG激光有助于减少长期局部治疗的并发症,实现更快的反应,并提高患者的依从性。

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