The Application Of Confocal Laser Scanning Microscopy In The Monitoring The Curative Effect Of Daivobet And The Diagnosis Of Leucoma Dermatosis

Objective:1.We use Daivobet,Calcipotriol Ointment and Betamethasone dipropionate topical in the treatment of vitiligo separately,and make a effect comparison of the three groups. We monitor the curative effect of the three groups by Confocal laser scanning microscopy(CLSM); judge the melanin recovery degree in the stratum basale and the other change of epidermis after treatment.2. We make a tentative exploration of the scanning image features of 6 kinds of leucoderma in clinical by CLSM and provide preliminary defining characteristics for clinical diagnosis.Method:1. Lesions of 36 cases of vitiligo were randomly divided into 3 groups and were given Daivobet,Calcipotriol Ointment and Betamethasone dipropionate topical separately. Evaluate the therapeutic effect of the three groups to the treatmen according to conventional clinical efficacy criteria of vitiligo 3-6 months after the treatment period. Monitor the melanin recovery degree in the stratum basale and the other change of epidermis of the three groups by CLSM during and after the treatment, Evaluation the actual pigment recovery degree difference and other changes of the three groups, thereby find the difference between the clinical and CLSM scanning recovery degree of vitiligo.2. We observe the lesions of 132 patients of leucoderma. Record melanin recovery degree in the stratum basale and the other change of epidermis and dermis by CLSM; reveal the image feature and difference of nevus anemicus,vitiligo,nevus depigmentosus,postinflammatory hypopigmentation,tinea versicolor and pityriasisalba preliminary.Results:1. Make a comparison of clinical curative effect of the three groups:the effective rate of Daivobet(group of A) is higher than Calcipotriol Ointment (group of B) and Betamethasone dipropionate(group of C) 3-6 months after the treatment period, Group A and B, C group also has a statistically significant differences of the effective rate, however Group B and C without significant difference; the clinical effective rate of three groups of different parts was not statistically significant differences 6 months after the treatment period; it has a statistically significant differences of the effective rate between active phase and stable phase of vitiligo however Group B and C without significant difference; the adverse reaction of the three groups was not statistically significant difference; the melanin recovery degree,dendritic melanophore existence or not and intercellular and Intracellular edema existence or not of the three groups has a statistically significant differences by CLSM after the treatment period.2. The scanning image features of 6 kinds of leucoderma in clinical by CLSM:the melanin in the stratum basale does not decrease in nevus anemicus;however the melanin of the other five kind of leucoderma decrease inordinately. Melanin distribution and reduce degree are diverse from each other.Conclusion:1. The clinical curative effect of Daivobet topical in the treatment of vitiligo is obviously better than Calcipotriol Ointment and Betamethasone dipropionate; The melanin recovery degree in the stratum basale and formation of dendritic melanophore of Daivobet are obviously better than other two groups.2. CLSM can be used for preliminary analysis and evaluation the melanin distribution and depigmentation degree of 6 kinds of leucoderma in clinical.