308-nm Excimer Laser Treatment Of Vitiligo Efficacy And Its Correlation With Nucleotide Excision Repair Genes Polymorphisms

Vitiligo is a common pigmentary disorder of the skin characterized by the Ivory depigmentation spots form different sizes and shapes formed by the whole mucocutaneous, and the lesion mainly involves the melanocytes. The current treatment methods include: topical corticosteroids, phototherapy, Melanocyte transplantation and others, the effects based on them are slow and unsatisfied. Being a novel method of phototherapy, 308 nm Excimer Laser has been cognized as a new method of treatment of vitiligo, however, there exists a lot of difference for different patients. According to the current studies, it is well known that ERCC1 C118 T of SNP in the NER genes is correlated with the treatment of vitiligo of NB-UVB, from the genetic point of view, the reasons of individual differences in the efficacy of NB-UVB treatment of patients with vitiligo are explained. There are not the previous researches on the association between geneticpolymorphisms of NER genes and 308 nm Excimer Laser phototherapy prognosis. If the reasons of 308 nm excimer laser for the treatment of the difference in the response of different patients could be explored, it can be used to guide the clinical treatment, and make appropriate treatment formulations for different patients, which can save time and cost of treatment for the patients and clinical significance. In this paper, there are two contents. On the one hand, clinical observation from 422 vitiligo patients with standard treatment in an 308 nm excimer laser are made and the clinical features of 308 nm excimer laser treatment are summarized, and then the efficacy safetyis analyze and evaluated. On the other hand, the Han Population in HeBei are determined as the object of study, and then 66 vitiligo patients with the treatment of 308 nm excimer laser are selected in order to test the SNPs distribution frequency difference of key gene ERCC1 C118 T and XPC Lys939 Gln in NER, and analyze the association between different gene types of ERCC1 C118 T and XPC Lys939 Gln and 308 nm excimer laser, which could provide new clues for the clinical treatment of vitiligo. Part 1 Clinical observation of 308 nm excimer laser in the treatment with vitiligoObjective:Through clinical characteristics of 308 nm excimer laser in the treatment with vitiligo,we analyze the correlative factors influencing the treatment effect, and evaluate its efficacy and safety.Methods:Selecting 422 vitiligo patients with standard treatment of 308 nm excimer laser as subjects between August 2013 and August 2015 in the department of dermatology from Affiliated Hospital of Hebei University of Engineering, we carry out statistics on pigment recovery after the standard treatment of 1045 depigmented patches for 3 courses of treatment( 10 times as a course of treatment), and analyze and appraise the correlation between different ages、 stages、 skin types、 parts、treatment times、 course of disease and treatment effect.Results:After the treatment of 1045 depigmented patches, the total cure rate was 81.63% and excellence was 65.56%. In 3 course of treatment times, the treatment effect is positive relation to treatment times; The best efficacy is observed in the face and neck、the external genitals, followed by the trunk and Limbs and the armpit and groin. The lesions on finger and lip showed a poorer response compared with those at other sites; and it shows that the shorter the duration, the better effect; the adult and children patients have considerable effect; Treatment effects between type ⅲand type Ⅳpatients with dermatosis have no significant difference. The effect is not related to the stage of disease, and there were no significant differences during treatment, which can be tolerated for most patients.Conclusion:308nm excimer laser in the treatment with vitiligo is is quick effect,good curative effect pain few during treatment,few side effects,better acceptance in patients.But its longterm safety and effectiveness should be further observed. Part 2 Relevant research of genetic polymorphisms of nucleotide excision repair(NER) and treatment effect 308 nm excimer laser in the treatment with VitiligoObjective:Testing two SNPs in NER pathway:polymorphisms of ERCC1 C118-T rs11615 and XPC Lys939 Gln rs2228001,explore its correlation with 30-8nm excimer laser in the treatment with vitiligo.we analyze the reasonsof the difference of 308 nm excimer laser in the treatment with vitiligo at gene level,and then forecast the reactivity for patients with different ge-notypes, in order to save time and treatment cost,and to make patients get more revenue. It is of great significance in providing new clues and theoretical basis for the treatment of vitiligo.Methods:Based on the Affiliated Hospital of Hebei University of Engineering, we select 66 vitiligo patients with standard treatment in an 308 nm excimer laser as subjects between August 2013 and August 2015 in the department of dermatology. we observe the treatment characteristics of the patients and meanwhile collect the peripheral blood of patients with 5ml that is used to extract DNA. After collecting blood samples, we use the PCR-RFLP for gene classifying of XPC Lys939Gln、ERCC1 C118 T in the SNP, in order to analyze the reactivity of 308 nm excimer laser from patients of different genotypes.Results:Through the statistical analysis, it is found that the patients carrying ERCC1 C118 T CC genotype is better treatment response to those carrying TT and CT combined genotypes for 308 nm excimer laser, which reflects in ahead of repigmentation time, the increase of repigmentation degree, less treatment, lower cumulative therapy dosage.(P=0.035;P =0.036;P =0.028;P =0.034). And there is no significant difference in treatment effect of 308 nm excimer laser for different genotypes patients in XPC Lys939 Gln SNP.Conclusion:1 ERCC1 C118 T of SNP is significant correlation with the treatment of 308 nm excimer laser of vitiligo of NB-UVB, Patients with CC gene have better prognosis than those with CT and TT combined gene.2 XPC Lys939 Gln of SNP has no significant correlation with the treatment of 308 nm Excimer Laser of vitiligo of NB-UVB.