Fractional Carbon Dioxide Laser Combined With 308nm Excimer Light In The Treatment Of Localized Vitiligo

Objective To explore the therapeutic effect of ractional carbon dioxide laser combined with 308 nm excimer light on localized vitiligo,and to provide reference for the diagnosis and treatment of localized vitiligo.Methods Collecting 70 patients with non segmental and undetermined types of localized vitiligo diagnosed in our outpatient department,totaling 141 lesions since October 2019 to August 2020.Dividing patients into treatment group(72 lesions)and control group(69 lesions)randomly,35 in each group.The treatment group was treated with fractional carbon dioxide laser combined with 308 nm excimer light,oral vitiligo capsule and tacrolimus was used for local external treatment.The control group was treated with 308 mn excimer light local irradiation,and vitiligo capsule were taken orally,and tacrolimus was used for local external treatment.After 12 weeks of treatment,analyzing the clinical efficacy and adverse reactions of the two groups were statistically,and evaluating their efficacy and safety.Results1.Compared with the control group,the significant efficiency of the experimental group was 75.00% and 49.28%,respectively,the difference was statistically significant(P<0.05);The effective rates were 95.83% and 84.06%,and the difference was statistically significant(P<0.05).The effect is different at different positions of the patients of the experimental group patients,the face and neck skin lesions(40),trunk and limbs lesion(26),limb end skin(6)treatment efficiency are 92.50%,61.54% and16.67% respectively,three sets of parts have significant difference was detected in statistical significance(P < 0.05),treatment effectiveness is 100.00%,96.15% and66.67% respectively,with statistical difference(P < 0.05).The effect is different at different positions of the control group patients,face and neck skin lesions(39),trunk and limbs lesion(22),limb end skin lesions(8)treatment efficiency are 71.79%,27.27% and 0.00% respectively,three sets of parts have significant difference was detected in statistical significance(P < 0.05),treatment effectiveness is 97.44%,86.36%and 12.50% respectively,with statistical difference(P < 0.05).2.According to Fitzpatrick’s skin classification,the patients in the experimental group belong to type III lesions(28 lesions)and type IV lesions(44 lesions),the apparent efficiency after treatment was71.43% and 77.27%,respectively,with no statistical significance(P > 0.05);the effective rate after treatment was96.43% and 95.45%respectively,with no statistical significance(P > 0.05).The patients in the control group belong to type III lesions(23 lesions)and type IV lesions(46 lesions),the apparent efficiency after treatment was60.87% and 43.48%,respectively,with no statistical significance(P > 0.05);the effective rate after treatment was82.61% and 84.78%respectively,with no statistical significance(P > 0.05).3.There was a significant difference in the effective rate about skin lesions of the face and neck between the experimental group and the control group(P < 0.05),and there was a significant difference in the effective rate about skin lesions of the trunk and limbs between the experimental group and the control group(P <0.05).There was no significant difference in the effective rate about skin lesions of the extremities between the experimental group and the control group(P >0.05).4.In both groups,a small number of patients had adverse reactions in the course of treatment.The main adverse reactions were erythema,blisters,mild pain,burning sensation,pruritus and so on.All the adverse reactions were within the range of acceptance of the patients and disappeared within 72 hours.Conclusion1.The efficacy of fractional carbon dioxide laser combined with 308 nm excimer light in the treatment of stable localized vitiligo is better than that of 308 nm excimer light alone,and the therapeutic effect of fractional carbon dioxide laser combined with 380 nm excimer light on skin lesions of face,neck and trunk is better.2.Fractional carbon dioxide laser combined with 308 nm excimer light and 308 nm excimer light alone in the treatment of stable localized vitiligo showed that the curative effect was different in different parts,the best in the face and neck,the second in the trunk and extremities,and the worse in the extremities.3.During the treatment of stable localized vitiligo with fractional carbon dioxide laser combined with 308 nm excimer light,there will be local skin pain,mild flushing,blisters and other adverse reactions,but these adverse reactions can disappear within 72 hours,do not affect the treatment,and are within the range of patients’ acceptance.There are no other serious adverse reactions,such as homomorphic reaction,scar and so on.The treatment is safe and effective.