Publication:

A comparative study of fractional carbon dioxide laser, narrowband ultraviolet B and topical tacrolimus 0.1% ointment versus narrowband ultraviolet B, topical tacrolimus 0.1% ointment in stable vitiligo

Background Vitiligo, an acquired pigmentary disorder of skin and mucous membrane characterized by well circumscribed depigmented macules that occur secondary to selective destruction of melanocytes. Fractional CO2 laser system is a recent advancement in the treatment of vitiligo which works on the concept of fractional photo-thermolysis, in which microscopic treatment zones are created which help in increasing the penetration of topically applied agent which indirectly improves drug efficacy.

Methods A comparative study was conducted on 40 patients of stable vitiligo attending OPD, Dept of DVL with fractional CO2 laser, narrowband ultraviolet B (NBUVB) and topical tacrolimus 0.1% vs NBUVB, topical tacrolimus 0.1% for a duration of 4 months and patients were followed up for 12 weeks post treatment.

Results Patients on Fractional CO2 laser in combination with NBUVB and topical tacrolimus 0.1% ointment showed >50% improvement compared with other group, with duration for initiation of pigmentation being comparatively less.

Conclusions The treatment protocol with CO2 laser in combination with topical tacrolimus 0.1% cream and NBUVB for stable vitiligo was more effective than NBUVB and topical tacrolimus 0.1% alone and this study demonstrates that adding fractional CO2 laser improves repigmentation rate of vitiliginous lesions.