Combined treatment with fractional carbon dioxide laser, autologous platelet-rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: A prospective, randomized comparative trial.

BACKGROUND

Multiple treatment options are introduced in treatment of vitiligo but the response is unsatisfactory.

OBJECTIVE

In this prospective, randomized, comparative trial, we studied the effect of combined treatment with fractional carbon dioxide (CO2 ) laser, platelet-rich plasma (PRP) injection, and narrowband ultraviolet B (NB-UVB) for stable nonsegmental vitiligo regarding repigmentation grade, patient's satisfaction, and side effects.

METHODS

Eighty adult patients with localized nonsegmental vitiligo were enrolled in this study. The patients were randomly categorized to receive 4 lines of treatment; fractional CO2 laser, PRP, combined fractional CO2 laser and PRP, and combined fractional CO2 laser and NB-UVB. The treatment period was 2 months. Patients were clinically evaluated 3 months after the last treatment. Outcome was evaluated by 5-point scale for repigmentation, 10-point visual analog scale for patient's satisfaction, and side effects.

RESULTS

Laser and PRP group achieved the best results regarding repigmentation and patient's satisfaction. Sixty percent of the patients developed repigmentation >50% and 40% of patients developed repigmentation >75%. In laser and NB-UVB group, 5% developed repigmentation >75% and 25% developed repigmentation >50%. Only 10% of patients developed repigmentation >75% in laser group and only 20% of patients developed repigmentation >75% in PRP group.

CONCLUSIONS

Combination of fractional CO2 laser with PRP injection is a promising treatment for vitiligo, followed by combination of fractional CO2 laser with NB-UVB phototherapy. Both fractional CO2 laser and PRP injection gave poor results if they received alone.