Correlation of clinical efficacy and psychosocial impact on vitiligo patients by excimer laser treatment

• Published in: Annals of Saudi medicine 2014-03, Vol.34 (2), p.115-121
• Main Author: Al-Shobaili, Hani A
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Adult; Age; Dermatology; Female; Humans; Lasers; Lasers, Excimer - therapeutic use; Low-Level Light Therapy - adverse effects; Low-Level Light Therapy - methods; Male; Middle Aged; Original; Patient satisfaction; Prospective Studies; Psychological aspects; Quality of Life; Questionnaires; Skin; Skin Pigmentation - radiation effects; Treatment Outcome; Vitiligo; Vitiligo - psychology; Vitiligo - radiotherapy; Young Adult
• ISSN: 0256-4947; 0975-4466
• DOI: 10.5144/0256-4947.2014.115

Vitiligo is a difficult disease to treat. Recently, a 308-nm excimer laser has been shown to be effective in treating vitiligo. In addition, the patients with vitiligo have impairment in their quality of life. The aim of the study was to investigate the clinical efficacy, safety, and psychosocial impact after treating vitiligo with the 308-nm excimer laser. A prospective clinical trial conducted at dermatology clinics of hospitals affiliated with Qassim University, Saudi Arabia, from May 2012 to February 2013. Forty-eight patients with 105 vitiliginous patches were treated using a 308-nm excimer laser. The treatment was performed twice per week for a maximum of 48 treatments or 100% repigmentation of lesions whichever was achieved first. The assessment of the clinical response and recording of side effects were performed biweekly. Out of 105 lesions in these patients, 63 lesions (60.0%) achieved over 75% repigmentation by laser treatment, 12 lesions (11.4%) showed 51% to 75% repigmentation, 9 lesions (8.6%) showed 26% to 50% repigmentation, and another 9 lesions (8.6%) showed 1% to 25% repigmentation, while 12 lesions (11.4%) showed no repigmentation. The average (+/-standard deviation [SD]) number of sessions needed to achieve repigmentation was 16.8 (8.0), whereas the average (+/-SD) number of sessions needed to realize Grade IV repigmentation was 20.2 (15). The type of repigmentation varied between lesions. Diffuse repigmentation was the most common pattern and occurred in 34 lesions (36.6%). Facial lesions responded better than lesions located elsewhere. Skin type did not play a statistically significant role (P=.07) in the lesions response to treatment. All side effects were mild and disappeared shortly after end of treatment sessions. The clinical data indicate that the treatment of vitiligo using the 308-nm excimer laser is effective and safe and improves psychosocial quality of life. Lesion location, duration of disease, and treatment duration are factors affecting the clinical and psychological outcome.