Effect of excimer laser treatment on vitiliginous areas with leukotrichia after confirmation by dermoscopy.

BACKGROUND

Leukotrichia is clinically common in patients with vitiligo, and dermoscopy is useful for finding white vellus hair. The use of phototherapy in the repigmentation of vitiliginous areas with leukotrichia is usually difficult because of a deficient melanocyte reservoir.

OBJECTIVES

We sought to evaluate the effect of leukotrichia on the clinical outcomes of excimer laser treatment.

METHODS

We treated 77 patients with vitiligo using excimer laser therapy. Vitiligo is classified into two types: segmental vitiligo (SV) and nonsegmental vitiligo (NSV). Before starting the treatment, we confirmed the leukotrichia of vitiliginous lesions by dermoscopy and then treated the areas once weekly for 24 weeks. At the beginning and 24 weeks later, we took clinical pictures and graded the repigmentation from 1 to 4. Grades 1 and 2 were defined as a poor response and grades 3 and 4 as a good response.

RESULTS

Thirty-one of 77 patients with vitiligo had SV. Among those with SV, 24 (77.4%) had leukotrichia, and these patients showed a poor response compared to those without leukotrichia (P = 0.272). Three of 24 patients with SV and leukotrichia showed a good response. Among the 46 patients with NSV, 18 (39.1%) had leukotrichia and showed a poor response. Twenty-eight (60.9%) of the 46 patients with NSV without leukotrichia showed a good response in contrast to those with leukotrichia (P < 0.01). Comparison of the response to the excimer laser treatment, regardless of vitiligo type, showed that leukotrichia was a significant negative factor in the repigmentation of vitiliginous areas (P < 0.01).

CONCLUSION

Excimer laser therapy was satisfactory in patients with vitiligo, including SV. Confirming the presence of leukotrichia in patients with vitiligo before excimer laser treatment would be helpful in predicting the response to treatment.