Ablative fractional Co2 laser aided delivery of long-acting glucocorticoid in the treatment of acral vitiligo: a multicenter, prospective, self-bilateral controlled study.

Background

Acral vitiligo often responses poorly to treatments.

Objective

To observe whether pretreatment with ablative fractional CO2 laser aiding penetration of compound betamethasone solution plus NB-UVB could improve the response of refractory acral vitiligo.

Methods

Subjects with symmetrical and stable acral vitiligo were enrolled in this study. The symmetrical lesions were randomly allocated to experimental and control sides in a subject. The experimental side underwent five sessions, one month apart, of ablative fractional CO2 laser followed by once of a topical painting of compound betamethasone solution, the control side applied topical betamethasone cream once a day; both sides underwent NB-UVB three times per week. The assessment was performed one month following each of the 1st, 2nd, 3rd, and 5th treatment sessions.

Results

Two hundred eighty-nine subjects entered the clinical trial and 126 subjects completed the study. The experiment side showed better improvement in repigmentation. Overall response rate (repigmentation percentage ≥10%) of experiment sides was 51.6%, in contrast, that of control side was 35.8%. There were no severe adverse events in all subjects during the trial.

Conclusions

A triple method of ablative fractional CO2 laser, topical compound betamethasone solution plus NB-UVB provided an alternative choice for acral vitiligo with remarkable safety profile. Cinical trial registration: This clinical trial has been registered at Chinese Clinical Trial Registry (Registration number: ChiCTR-TRC-12002593).