Combination treatment with excimer laser and narrowband UVB light in vitiligo patients.

BACKGROUND: For the treatment of vitiligo, narrowband UVB (NBUVB) light is considered the most effective for nonsegmental vitiligo, while excimer laser treatment is commonly used for localized vitiligo. However, treatment areas may potentially be missed with excimer laser treatment. OBJECTIVE: We aimed to evaluate the effect of combinational treatment with NBUVB light and excimer laser on vitiligo. METHODS: All patients were first treated with NBUVB; excimer laser was then applied in conjunction with NBUVB phototherapy due to a slow response or no further improvement with continuous NBUVB treatment alone. To minimize adverse effects, a fixed dose of NBUVB was administered, and the dose of excimer laser was increased based on patient response. RESULTS: Among 80 patients, 54 patients showed responses after combination with excimer laser; however, 26 patients (32.5%) showed no remarkable change after combination therapy. Of the 26 patients who showed no further response, 12 patients (46.1%) presented with vitiligo on the acral areas, which are known to the least responsive sites. CONCLUSION: Our study suggests that combined treatment of NBUVB and excimer laser in vitiligo may enhance the treatment response without remarkable side effects, therefore might also increase the compliance of the patients to the treatment.

Comparison of non-ablative and ablative fractional laser treatments in a postoperative scar study.

BACKGROUND AND OBJECTIVE: Postoperative scarring after thyroidectomy is a problem for both patients and clinicians. Recently, both non-ablative and ablative fractional laser (NFL and AFL) systems have attracted attention as potential therapies for the revision of thyroidectomy scars. The present split-scar study was designed to directly compare the efficacy of these two methods for the treatment of post-thyroidectomy scars. STUDY DESIGN/MATERIALS AND METHODS: Twenty females (mean age 42.1 years, range 22-55) with scarring 2-3 months post-thyroidectomy were enrolled in the study. One half of the scar (chosen at random) was treated with NFL and the other half was treated with AFL. In each case, two treatments were given at 2-month intervals. Clinical photographs were taken at baseline, before each treatment, and at the final 3-month evaluation. Independent clinician grading of improvement and patient satisfaction were measured on a quartile scale. Color (erythema and melanin indices) and scar hardness were measured at baseline and at three months post-treatment with a dermaspectrometer and durometer, respectively. RESULTS: The mean clinical improvement grades for AFL and NFL were highly similar, 2.45 ± 0.99 and 2.35 ± 0.85, respectively, without statistical significance (P = 0.752). However, NFL treatment resulted in statistically significant changes in erythema and pigmentation (P = 0.035 and P = 0.003, respectively), and skin hardness was significantly reduced after AFL treatment (P = 0.026). CONCLUSIONS: Clinical improvement was not significantly different between the two systems; however, AFL was better at reducing scar hardness whereas NFL was superior for lightening color. These data suggest that a study assessing the feasibility of a combined approach for the revision of post-thyroidectomy scarring might be warranted.

The effects of a multigrowth factor-containing cream on recovery after laser treatment: a double-blinded, randomized, split-face controlled study.

BACKGROUND: Patients who receive laser treatments may experience transient erythema, edema, and crusts for several days. Although a variety of growth factor-containing creams for promoting recovery after laser treatment are available, evidence for their efficacy remains insufficient. AIMS: We performed a randomized controlled split-face study to assess the effects of a multigrowth factor (MGF)-containing cream on patients recovering from laser treatment. MATERIALS AND METHODS: Twenty patients underwent treatment using an ablative fractional laser and were randomized with respect to the side of the face treated with an MGF-containing cream or control cream. We measured post-treatment erythema and pigmentation using the erythema and melanin indices, respectively, and evaluated the total area of microcrusts with dermoscopy. Additionally, patient satisfaction levels and global improvement scores were assessed. RESULTS: We found that the area of microcrusts was significantly smaller in the MGF-treated regions. Global improvement scores for post-treatment edema and wrinkles were also significantly higher for MGF cream-treated sides than for the control sides. CONCLUSION: The MGF cream-treated regions showed a more rapid recovery from crusts and edema. Thus, the use of an MGF-containing cream after laser treatment can effectively reduce recovery time.

The Effects of Multi-Growth Factors-Containing Cream on Post-Thyroidectomy Scars: A Preliminary Study.

BACKGROUND: Growth factors play important roles in wound healing. However, the evidence for the effects of growth factors on post-thyroidectomy scars is limited. OBJECTIVE: We performed a prospective study to assess the preventive and therapeutic effect of a multi-growth factor (MGF)-containing cream on post-thyroidectomy scars. METHODS: Twenty-one patients with thyroidectomy scars applied MGF cream twice a day. We assessed the changes in erythema, pigmentation, skin elasticity, and skin hydration status using the erythema index, melanin index, cutometer, and corneometer, respectively. In addition, Vancouver scar scale (VSS) and patient satisfaction were assessed at 10 days after surgery (baseline), 2 weeks, 6 weeks, and 12 weeks after baseline. RESULTS: The mean total VSS scores were significantly lower at 6 weeks (3.24±1.51 vs. 1.91±1.38) and 12 weeks (3.24±1.51 vs. 1.71±1.59) compared to the baseline. The degree of pigmentation was significantly lower at 12 weeks compared to the baseline, and the skin elasticity, and the skin hydration status were significantly higher at 12 weeks compared to the baseline. Over 85% of the patients were satisfied with the use of MGF cream without any adverse effect. CONCLUSION: MGF cream might have additive or supportive effect for scar formation after thyroidectomy.