Faculty of Medicine, Department of Dermatology, Venerology and Andrology, Assiut University Hospital, Assiut, Egypt.
Faculty of Medicine, Department of plastic surgery, Assiut University Hospital, Assiut, Egypt.
J Cosmet Dermatol. 2021 Sep;20(9):2894-2905. doi: 10.1111/jocd.13922. Epub 2021 Jan 24.
Follicular unit extraction (FUE) grafting is a surgical procedure which provides the vitiliginous patches with undifferentiated stem cells of the hair follicles. It has been postulated that adjuvant therapy enhances the results. This is the first study to assess two different adjuvant therapies vs FUE alone.
To study the efficiency of FUE alone or combined with either topical calcipotriol betamethasone dipropionate (CBD) or NB-UVB phototherapy in cases of nonsegmental stable vitiligo. To assess the role of dermoscopy in monitoring the pattern and degree of repigmentation.
PATIENTS/ METHODS: 53 patients with 94 lesions with stable nonsegmental vitiligo were divided into three groups. Group 1 (n = 16) with 30 lesions received FUE alone. Group 2 (n = 18) with 32 lesions received FUE plus topical CBD. Group 3 (n = 19) with 32 lesions received FUE plus NB-UVB phototherapy. Assessment was done by grades of repigmentation, color match, percent of size reduction, and immunohistochemical evaluation of perilesional CD8+T lymphocytes.
The fastest onset of repigmentation was observed in both groups 2 and 3 in the second week (16.7%, 10.5%, respectively).Group 2 achieved the best response by all methods of assessment. Perifollicular diffuse repigmentation was the commonest dermoscopic pattern in 60 lesions (63.8%). There was a statistically significant decrease in perilesional CD8+T lymphocytes after 4 months.
FUE is an effective method of surgical treatment of stable vitiligo, and topical CBD as a new adjuvant therapy is successful in targeting the immunological background of vitiligo. Dermoscopy has an essential role in monitoring the repigmentation response.
毛囊单位提取（FUE）移植是一种为白癜风斑块提供未分化毛囊干细胞的外科手术。有观点认为辅助治疗可以增强疗效。这是第一项评估 FUE 单独应用与 FUE 联合外用钙泊三醇倍他米松（CBD）或 NB-UVB 光疗在非节段性稳定白癜风中的作用的研究。目的：研究 FUE 单独或联合外用 CBD 或 NB-UVB 光疗治疗非节段性稳定白癜风的疗效。评估共聚焦激光皮肤显微镜在监测复色模式和程度中的作用。
患者/方法：53 例 94 处非节段性稳定白癜风患者分为三组。第 1 组（n=16，30 处皮损）接受 FUE 治疗。第 2 组（n=18，32 处皮损）接受 FUE 联合外用 CBD 治疗。第 3 组（n=19，32 处皮损）接受 FUE 联合 NB-UVB 光疗。通过复色等级、颜色匹配、面积缩小百分比和皮损周围 CD8+T 淋巴细胞免疫组化评估进行评估。
第 2 组和第 3 组在第 2 周时观察到最快的复色（分别为 16.7%、10.5%）。第 2 组在所有评估方法中均取得了最佳疗效。60 处皮损最常见的共聚焦激光皮肤显微镜模式为毛囊周围弥漫性复色（63.8%）。治疗后 4 个月，皮损周围 CD8+T 淋巴细胞数量显著减少。
FUE 是治疗稳定期白癜风的有效方法，外用 CBD 作为一种新的辅助治疗方法，成功地针对白癜风的免疫学背景。共聚焦激光皮肤显微镜在监测复色反应中具有重要作用。
