Dynamic Monitoring Of 308nm Excimer Laser Combined With Drug Therapy For Pigment Recovery Of Vitiligo By Dermatoscope

Objective(1)The results of dynamic monitoring of pigmentation in 47 patients with vitiligo in face,neck and trunk after treatment with 308 nm excimer laser combined with drug therapy by the naked eyes and dermatoscope respectively were analyzed and compared.To find a more objective monitoring method for vitiligo.(2)Observed the performance of different stages of vitiligo and the pattern of pigment growth in the process of recoloration under the dermatoscope.Methods A total of 47 patients with vitiligo of the face,neck and trunk of Ningxia Medical University from January to August,2017 were collected.All 47 patients were treated with the same regimen(308nm excimer laser irradiation twice/week,oral compound anthelmintic chrysanthemum pills and compound glycyrrhizin tablets,topical tacrolimus ointment and Xiaobai ointment),a total of 12 weeks of treatment.Dermatoscopy and naked eye monitoring were carried out at 0 week,4 weeks and 8 weeks to 12 weeks after treatment.The monitoring effects of the two methods were compared and analyzed by statistical method,and the difference of monitoring effect between the two methods was obtained.At the same time,the performance of different stages of 47 cases of vitiligo patients and the pattern of pigment growth in the process of recoloration were observed under the dermatoscope.Results Through the naked eyes observation,in the patients with pigment growth in the vitiligo lesions,it could be seen under the dermatoscope that there were obvious pigmentgrowth.Through visual observation,in patients with no obvious pigmentation in the lesions of vitiligo,under the dermatoscope,some patients did not see significant pigmentation,and some patients could see a little pigmentation.By visual observation,vitiligo was treated with an average effective rate of 21.28% after 4 weeks,an average effective rate of 46.81% after 8weeks,and an average effective rate of 76.60% after 12 weeks.To observe through the dermatoscope,vitiligo was treated with an average effective rate of 34.04% after 4 weeks,an average effective rate of 61.70% after 8 weeks,and an average effective rate of 91.49% after12 weeks.After statistical analysis,the differences were statistically significant(P <0.05).Under the dermatoscope,progressive vitiligo was characterized by ivory white background,residual pigment around the hair follicles,fuzzy boundaries,lesions surrounded by hypopigmented spots of different sizes or shapes.In contrast,stable vitiligo was characterized by porcelain white background,clear boundaries and hyperpigmentation around the lesions.Likewise,regression vitiligo was also characterized by clear boundaries,residual pigment around the hair follicles,hyperpigmentation around the lesions,and pigment islands.The formation of pigment island around the hair follicle and the formation of the marginal pigment island were mainly observed in the early stage of the pigmentation process of vitiligo,and diffuse pigment growth could be seen in the late stage.After careful analysis,it was found that the pigment growth pattern of vitiligo had no significant relationship with sex,lesion location,disease stage,age and course of disease.Conclusion(1)The dermatoscope technology can detect pigment islands that are not easily visible to the naked eye in an early stage,and can objectively,accurately,and timely evaluate the therapeutic effect of vitiligo,increase the confidence of patients in treatment,improve the dependence,and further improve the cure rate.It can be used as an effective monitoring method in the treatment of vitiligo.(2)Different stages of vitiligo have different performance under the dermatoscope and the dermatoscope can help stage the disease.(3)The pigmentation pattern of vitiligo under the dermoscope is the formation of pigment island around the hair follicle and the formation of the marginal pigment island in the early stage and the diffuse pigment growth in the late stage.(4)No correlation was found between the pigment growth pattern and sex,lesion location,disease stage,age and course of disease in patients with vitiligo.