Chen Wei, Zhou Yuan, Huang Fei-Ran, Luo Dan, Wang Da-Guang
Department of Dermatology, The First Affiliated Hospital with Nanjing Medical University, Guangzhou Road 300, Nanjing City, Jiangsu Province, China 210029.
Lasers Surg Med. 2018 Oct;50(8):829-836. doi: 10.1002/lsm.22821. Epub 2018 Apr 10.
Tacrolimus is a conventional medication for the treatment of vitiligo, but the effect of a single medication is limited.
This paper aims at observing the effects, adverse responses, and repigmentation results of the joint treatment of vitiligo by Carbon dioxide (CO ) fractional laser together with tacrolimus.
Forty-five patients with vitiligo were randomly divided into two groups: treatment (T) group and control (C) group, and each group was further divided into three subgroups (face, torso and limbs, and hand and foot) according to the location of the skin defect. Both groups used topical 0.1% tacrolimus cream, but the T group was given one CO fractional laser treatment each month. We observed the clinical efficacy, adverse responses, and repigmentation results after 6 months.
Compared to the C group, the T group showed better improvement in both objective and subjective assessments. When the treatment time was increased, the efficacy was also improved, and the repigmentation in the T group occured in three ways: perifollicular repigmentation, marginal repigmentation and diffuse repigmentation. There were three cases of isomorphic responses (2 cases in the rapid progression stage, one case in the progression stage), and 1 case formed scarring on the neck in the T group.
The treatment of vitiligo by CO fractional laser together with tacrolimus is significantly effective and is most suitable for patients in the progression stage. Patients in the rapid progression stage should use this approach with caution, and its efficacy was limited for patients in the stable stage. An extended course of treatment is helpful for the repigmentation of white patches. All three forms of repigmentation can occur in the joint treatment of vitiligo by CO fractional laser together with tacrolimus. Lasers Surg. Med. 50:829-836, 2018. © 2018 Wiley Periodicals, Inc.
他克莫司是治疗白癜风的常用药物，但单一药物治疗效果有限。
观察二氧化碳（CO₂）点阵激光联合他克莫司治疗白癜风的疗效、不良反应及复色情况。
将45例白癜风患者随机分为治疗（T）组和对照（C）组，每组再根据皮损部位分为三个亚组（面部、躯干四肢、手足）。两组均外用0.1%他克莫司乳膏，但T组每月给予1次CO₂点阵激光治疗。观察6个月后的临床疗效、不良反应及复色情况。
与C组相比，T组在客观和主观评估方面均有更好的改善。随着治疗时间的增加，疗效也有所提高，T组的复色有三种方式：毛囊周围复色、边缘复色和弥漫性复色。T组有3例同形反应（快速进展期2例，进展期1例），1例颈部形成瘢痕。
CO₂点阵激光联合他克莫司治疗白癜风疗效显著，最适合进展期患者。快速进展期患者应谨慎使用该方法，对稳定期患者疗效有限。延长疗程有助于白斑复色。CO₂点阵激光联合他克莫司治疗白癜风可出现三种复色形式。《激光外科与医学》50:829 - 836, 2018。© 2018威利期刊公司。
