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

Abstract

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)

Keywords:

• Ablative fractional laser
• betamethasone compound
• acral
• vitiligo

Acknowledgements

We would like to acknowledge Chen Yu, MM, Yuwei Zhang, MM, Yangzi Tian, MM (Department of Dermatology, Xijing Hospital, Fourth Military Medical University, China), and Qian An, MM (Department of Dermatology, The First Hospital of China Medical University, China), for their contributions to the recruitment of patients and data management for this study. This study was approved by the Institutional Review Board of The First Hospital of China Medical University (Leading Unit).

Disclosure statement

The authors have no conflict of interest to declare and all authors have signed the copyright agreement.

Additional information

Funding

This work was funded by the Public Welfare Program, Ministry of Health, China [201202013] and the National Natural Science Foundation of China [No. 81130032 and 81472893].