title: Carbon dioxide laser plus topical 5-fluorouracil: a new combination therapeutic modality for acral vitiligo.
abstract: BACKGROUND
  Acral vitiligo (AV) is resistant to treatment.
  
  
  OBJECTIVE
  To evaluate efficacy and safety of combining carbon dioxide (CO2) laser and 5-fluorouracil (5FU) in treating AV.
  
  
  METHODS
  This study included 68 adult patients with AV. After randomly assigning patients into 3 groups, patients in group I were treated using 5FU, group II were treated using CO2 laser, and group III were treated using CO2 laser followed by 5FU for a maximum period of 5 months. The lesions were then evaluated both qualitatively and quantitatively.
  
  
  RESULTS
  Almost half (49.8%) of the lesions in group III achieved G4, and 6.1% of lesions achieved G3 re-pigmentation. This response was statistically significantly higher than that in the other two groups. This was not achieved in periungual areas in the hands and feet. The pain was tolerable during sessions or at sites of 5FU application. Transient hyperpigmentation, brownish spot on nail plates, itching, and infection were temporary side effects; however, Koebnerization was not detected.
  
  
  CONCLUSIONS
  We concluded that prior use of CO2 laser skin ablation, followed by 5FU application for AV is a safe and tolerable technique that improves the outcome and increases patient compliance.
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Suez Canal University , Ismailia , Egypt.
authors.forename: Hager A
authors.initials: HA
authors.lastname: Mohamed
authors.forename: Ghada F
authors.initials: GF
authors.lastname: Mohammed
authors.forename: Amal H A
authors.initials: AH
authors.lastname: Gomaa
authors.forename: Moustafa M K
authors.initials: MM
authors.lastname: Eyada
mesh_terms: D000328:Adult; D000963:Antimetabolites / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D063465:Skin Cream; D014820:Vitiligo / Q000532:radiotherapy*
chemical_list: D000963:Antimetabolites; D005472:Fluorouracil
keywords: 5-fluorouracil; CO2 laser; acral vitiligo; melanocyte