[Excimer laser treatment of vitiligo -- critical retrospective assessment of own results and literature overview].
BACKGROUND
In numerous studies the 308-nm excimer laser has been described as an effective therapy method for localized vitiligo. Our experience and critical evaluation of the relevant literature lead to a less enthusiastic endorsement.


METHODS
A total of 9 patients with localized vitiligo were evaluated in our retrospective study. The sessions took place 2-3 times per week; the energy dose was increased depending on the occurring side effects. The rate of repigmentation was evaluated in 5 grades: grade 0 = 0 %, grade 1 = 1-25 %, grade 2 = 26-50 %, grade 3 = 51-75 %,grade 4 = 76-100 %. Subjective patient satisfaction was rated "satisfied"/"not satisfied".


RESULTS
In face and neck areas we used a cumulative energy dose of 16.6 J/cm(2) and achieved repigmentation grade 4 in 33.3 %, grade 2 in 33.3 %, grade 1 in 11.1 % and no improvement in 22.2 % of the cases. On hands and knees we used a medium cumulative energy dose of 20.8 J/cm(2) and did not observe any tendency towards repigmentation. Four of the patients were satisfied, while 5 were not. Side effects (erythema, blisters, crusting and perilesional hyperpig-mentation) were transient in all cases. Within a medium observation period of 19.1 months, one patient had a relapse.


CONCLUSIONS
The excimer laser should be regarded as a treatment alternative in cases of localized vitiligo of the face. The treatment at other sites is clearly limited because of only partial repigmentation, considerable expense of time and money as well as the potentially higher risk of tumorigenesis.
Greve
Bärbel
B
Laserklinik Karlsruhe, Germany. greve@raulin.de
Raulin
Christian
C
Fischer
Edda
E
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012880:Skin Pigmentation / Q000528:radiation effects; D014820:Vitiligo / Q000532:radiotherapy*