Raizada Annie, Panda Maitreyee, Singh Bhabani Stp, Kar Bikash R
Department of DVL, Institute of Medical Sciences & SUM Hospital, Siksha O Anusandhan University, Bhubaneswar, Odisha, India.
J Cutan Aesthet Surg. 2021 Jan-Mar;14(1):55-63. doi: 10.4103/JCAS.JCAS_188_19.
The treatment of vitiligo is often challenging and requires a multi-modality approach. Fractional carbon dioxide (FCO) laser has been studied as an adjuvant therapy in cases of vitiligo. Autologous platelet-rich plasma (PRP) is rich in growth factors, which may contribute to the growth of melanocytes, and thus help in the repigmentation of vitiligo patches. We aimed to study the combination of these two modalities for the treatment of vitiligo.
The aim of this study was to compare the efficacy and safety of FCO laser with PRP and FCO laser alone as an adjuvant therapy in stable non-segmental vitiligo (NSV) patients.
A prospective, randomized, comparative, open-label interventional study was carried out for a period of 18 months from December 2017 to June 2019, at a tertiary care hospital.
Seventy patients with stable, NSV were assessed for eligibility; 66 patients were randomized equally into two groups. Group A received treatment with FCO laser with intralesional PRP, whereas Group B was treated with FCO laser alone. Patients in both the groups were treated with one therapy session and were followed up monthly for a period of 3 months. All the patients received topical psoralen with ultraviolet A (UVA) PUVA-sol treatment. Baseline and monthly assessments were done by VITILIGO AREA SEVERITY INDEX and standardized photographs.
VASI score reduction was significantly more in the Group A with (mean ± standard deviation [SD]) 9.5 ± 0.22, 5.8 ± 1.12, and 3.6 ± 1.81 as compared to Group B 11.9 ± 2.83, 9.9 ± 3.11, and 8.9 ± 3.46 at each subsequent follow-up visits, respectively. Side effects such as burning sensation, erythema, and crusting were seen less frequently and lasted for a short period in Group A in comparison to those in Group B.
Combination of FCO laser and autologous intralesional PRP has a synergetic effect in treating patients with vitiligo as an adjuvant therapy with minimal adverse effects.
白癜风的治疗通常具有挑战性，需要采用多模式方法。分次二氧化碳（FCO）激光已被研究作为白癜风病例的辅助治疗方法。自体富血小板血浆（PRP）富含生长因子，这可能有助于黑素细胞的生长，从而有助于白癜风斑块的复色。我们旨在研究这两种模式联合用于治疗白癜风。
本研究的目的是比较FCO激光联合PRP与单独使用FCO激光作为稳定型非节段性白癜风（NSV）患者辅助治疗的疗效和安全性。
2017年12月至2019年6月，在一家三级医院进行了一项为期18个月的前瞻性、随机、对照、开放标签的干预性研究。
评估70例稳定型NSV患者的入选资格；66例患者被平均随机分为两组。A组接受FCO激光联合皮损内注射PRP治疗，而B组仅接受FCO激光治疗。两组患者均接受一次治疗，并每月随访3个月。所有患者均接受外用补骨脂素联合紫外线A（UVA）光化学疗法（PUVA-sol）治疗。通过白癜风面积严重程度指数和标准化照片进行基线和每月评估。
与B组相比，A组在每次后续随访时的白癜风面积严重程度指数（VASI）评分降低更为显著，分别为（均值±标准差[SD]）9.5±0.22、5.8±1.12和3.6±1.81，而B组分别为11.9±2.83、9.9±3.11和8.9±3.46。与B组相比，A组的烧灼感、红斑和结痂等副作用出现频率较低，持续时间较短。
FCO激光与自体皮损内PRP联合作为辅助治疗白癜风患者具有协同作用，且不良反应最小。
