Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, 10th Floor, Cooperative Learning Center, Piyachart2 Building, 99 Moo 18, Phaholyothin Road, Klong Luang, Pathum Thani, 12120, Thailand.
Lasers Med Sci. 2020 Dec;35(9):2023-2029. doi: 10.1007/s10103-020-03048-5. Epub 2020 May 27.
Facial vitiligo has considerable psychological and emotional impacts. Though topical corticosteroids are the mainstay treatment, adverse reactions are a concern for prolonged use. Additionally, 308-nm excimer lamps have been widely used in vitiligo. This study aimed to assess the effectiveness of a combined 308-nm excimer lamp and topical steroid therapy compared with the lamp alone for treating facial vitiligo. Symmetrical, nonsegmental facial vitiligo subjects were recruited. All facial lesions were irradiated with a 308-nm excimer lamp twice weekly for a total of 24 sessions. The lesions on each side of the face were randomly allocated to have topical mometasone furoate cream or the cream base alone applied once daily for 12 weeks. Clinical improvement was evaluated by a blinded dermatologist and the participants. A total of sixteen sides of the face were assessed in the study. By the 12th week, 87.5% of the lesions treated with the combination regimen and 50% of the lesions treated with monotherapy showed good to excellent repigmentation. From the subjects' perspectives, there were significant differences between both treatments at week 4 and week 8 (p = 0.05) but not at week 12. No serious adverse effects were reported. A combination of excimer lamp therapy and once-daily application of topical mometasone cream was effective and could accelerate the treatment outcomes without serious adverse reactions. This may be an alternative regimen for treating facial vitiligo.
面部白癜风会造成相当大的心理和情绪影响。尽管局部皮质类固醇是主要的治疗方法,但长期使用会引起不良反应。此外,308nm 准分子灯已广泛用于白癜风治疗。本研究旨在评估 308nm 准分子灯联合局部皮质类固醇治疗与单独使用灯治疗面部白癜风的疗效。招募了对称性、非节段性面部白癜风患者。所有面部病变每周接受 308nm 准分子灯照射两次,共 24 次。面部两侧的病变随机分配接受局部糠酸莫米松乳膏或乳膏基质单独治疗,持续 12 周,每天一次。临床改善由盲法皮肤科医生和参与者评估。研究共评估了 16 侧面部。在第 12 周时,联合治疗组 87.5%的病变和单一治疗组 50%的病变显示良好至极好的复色。从患者的角度来看,两种治疗方法在第 4 周和第 8 周时差异有统计学意义(p=0.05),但在第 12 周时差异无统计学意义。未报告严重不良事件。准分子灯治疗联合每日一次局部糠酸莫米松乳膏治疗有效,且不会产生严重不良反应,可加速治疗效果。这可能是治疗面部白癜风的一种替代方案。