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Laser Therapy, Skin Ointment for Vitiligo

Combined Approach Shows Promise in French Study
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WebMD Health News

Sept. 20, 2004 - A new study shows that combining a special laser therapy and a skin ointment called tacrolimus may be better at helping repigment skin affected by vitiligo, according to French researchers.

Vitiligo is a disease characterized by patches of white, depigmented skin. Vitiligo affects an estimated 1%-2% of the world's population, including men and women of all races.

Vitiligo is caused by a complete absence of melanin, the body's skin-pigmenting chemical, in patches of affected skin. In addition to the disfiguring concerns, these skin areas are sun sensitive and have an increased risk of skin cancer.

Treatments have included numerous therapies that either completely remove skin pigmentation or various therapies, such as lasers and topical steroid creams, which aim to repigment the skin. According to the authors, no treatment has provided true satisfaction.

Recently, doctors from the Hôpital de l'Archet 2 in Nice, France, studied 14 vitiligo patients aged 12-63 to see if combining laser therapy and tacrolimus treatment would help repigment vitiligo lesions better than laser therapy alone.

Thierry Passeron, MD, and colleagues selected four to 10 vitiligo lesions on each patient.

Passeron's team treated the lesions with laser therapy twice a week for a total of 24 sessions, using an excimer laser.

In addition, patients also applied 0.1% topical tacrolimus twice daily to a selected group of lesions.

The combined therapy showed the best results.

Repigmentation was seen in all of the lesions receiving laser therapy and tacrolimus, compared with 85% of lesions that only received laser treatment.

Rates of repigmentation were also better in lesions receiving the combined therapy.

When the researchers looked at how well lesions could achieve at least 75% repigmentation, they found that 70% of lesions treated with the combined therapy achieved this goal compared with only 20% treated with laser alone.

Lesions not receiving any treatment did not show repigmentation.

Location of the lesions also mattered. Lesions in areas of the body that are especially sensitive to ultraviolet (UV) radiation responded better than those in UV-resistant areas. UV-sensitive areas include the face, neck, chest, arms, and legs, except for bony areas like knees and elbows and extremities like hands and feet.

"The combination of 0.1% tacrolimus ointment applied twice daily and 308-nm excimer laser therapy performed twice a week gives excellent results on UV-sensitive and UV-resistant areas. The treatment was well tolerated, and the patients were satisfied," write the researchers in the September issue of the Archives of Dermatology.

Passeron's team says the results are "encouraging" and call for larger studies to confirm their results.

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