title: Fractional CO2 Laser Pretreatment to Autologous Hair Transplantation and Phototherapy Improves Perifollicular Repigmentation in Refractory Vitiligo: A Randomized, Prospective, Half-Lesion, Comparative Study.
abstract: BACKGROUND
  Fractional CO2 laser and autologous hair transplantation are independently effective in the treatment of refractory and stable vitiligo.
  
  
  OBJECTIVE
  The authors' purpose was to evaluate the therapeutic efficacy of fractional CO2 laser pretreatment compared with autologous hair transplantation and phototherapy alone for refractory and stable vitiligo.
  
  
  METHODS
  A total of 20 patients with refractory and stable vitiligo were enrolled from our clinic. Resistant lesions randomly divided into 2 regions as follows: (1) Part A: fractional CO2 laser pretreatment followed by autologous transplantation and phototherapy, and (2) Part B: autologous transplantation and phototherapy alone. Five days after fractional CO2 laser application to Part A, both treatment regions received a transplant of scalp grafts. On Day 11, the entire lesion was exposed to narrow-band UVB phototherapy, twice a week for 12 weeks. The diameter of perifollicular repigmentation was measured monthly with a caliper.
  
  
  RESULTS
  Perifollicular repigmentation was detectable surrounding 74% of grafted hair follicles by Month 3. Furthermore, Part A demonstrated a significantly greater diameter of repigmentation with 6.6 ± 5.8 mm in Part A compared with 4.3 ± 1.8 mm in Part B (p = <.001).
  
  
  CONCLUSIONS
  In this study, our results demonstrate improved efficacy of autologous hair transplantation and narrow-band UVB with fractional CO2 laser pretreatment in refractory and stable vitiligo.
authors: *Department of Dermatology, Jahrom University of Medical Sciences, Jahrom, Iran; †Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran; ‡Department of Radiation Oncology, SUNY Downstate Medical Center, New York.
authors: Amir
authors: A
authors: Feily
authors: Vahid
authors: V
authors: Seifi
authors: Marigdalia K
authors: MK
authors: Ramirez-Fort
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D018859:Hair Follicle / Q000637:transplantation*; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies; D012880:Skin Pigmentation / Q000528:radiation effects*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014467:Ultraviolet Therapy; D014820:Vitiligo / Q000628:therapy*; D055815:Young Adult