Fractional CO2 laser is an effective therapeutic modality for xanthelasma palpebrarum: a randomized clinical trial.

BACKGROUND: Xanthelasma palpebrarum (XP) is a common cosmetic concern. Although there is a wide range of therapeutic modalities for XP, there is no general consensus on the optimal treatment for such condition. OBJECTIVE: Compare the efficacy and safety of super pulsed (SP) and fractional CO2 lasers in the treatment of XP. PATIENTS AND METHODS: This prospective randomized comparative clinical study included 20 adult patients with bilateral and symmetrical XP lesions. Xanthelasma palpebrarum lesions were randomly assigned to treatment by either single session of ablative SP CO2 laser or 3 to 5 sessions of ablative fractional CO2 laser with monthly intervals. All patients were assessed using digital photography and optical coherence tomography images. RESULTS: Xanthelasma palpebrarum lesions on both sides were successfully removed with significant improvement in size, color, and thickness. Although lesions treated by SP CO2 laser showed significantly better improvement regarding color and thickness of the lesions, downtime and patient satisfaction were significantly better for lesions treated with fractional CO2 laser. Scarring and recurrence were significantly higher in lesions treated by SP CO2 laser. CONCLUSION: Ablative fractional CO2 laser is an effective and safe therapeutic option for XP with significantly shorter downtime and higher patient satisfaction compared with SP CO2 laser.

Ultraviolet A in vitiligo.

Both types of Ultraviolet (UV), UVB (290-320 nm) and UVA (320-400 nm), produce increased pigmentation or tanning. However, no evaluation of UVA alone in the treatment of vitiligo has been reported. Therefore, it was the purpose of this work to study the pigmentogenic effect of UVA (5 and 15 J/cm(2)) in vitiligo. The study included 20 randomly selected patients with vitiligo involving more than 30% of the body surface area with a bilateral/symmetrical distribution. They were equally divided into two groups each of 10 patients. All patients received three weekly sessions of UVA, 15 J/cm(2) in group I and 5 J/cm(2) in group II, a total of 48 sessions over 16 weeks. Overall pigmentation of 60% and above was recorded in 50% and 10% of patients in groups I and II, respectively. We conclude that broadband UVA alone, without psoralens, and in appropriate doses may be of important therapeutic value in vitiligo.