Comparison of the efficacy of 308-nm excimer lamp monotherapy with topical tacrolimus or clobetasol 17-propionate combination therapies in localized vitiligo

Photodermatol Photoimmunol Photomed. 2016 Sep;32(5-6):247-253. doi: 10.1111/phpp.12266. Epub 2016 Sep 27.

Abstract

Background: In recent years, excimer light treatments have come to the fore in localized vitiligo because of their high efficacy and safety.

Objective: We aimed to evaluate the efficacy of 308-nm excimer lamp as a monotherapy and its combination with tacrolimus 0.1% or clobetasol 17-propionate 0.05% ointment in localized vitiligo.

Methods: We performed a retrospective study including a total of 82 patients who were treated with excimer lamp monotherapy (EL group) (n = 30), excimer lamp + topical tacrolimus (EL + T group) (n = 29), or excimer lamp + topical clobetasol 17-propionate (EL + CS group) (n = 23). We used digital morphometric analysis for the evaluation of repigmentation.

Results: Median healing rate after 24 sessions was significantly higher in EL + T group (69%) than EL (42.5%) and EL + CS (44%) groups (P = 0.008 and P = 0.032). There were not any patients with face lesions in EL + CS group, so when these patients were excluded, EL + T and EL + CS groups had higher healing rates than EL group (P = 0.037 and P = 0.043). It was confirmed that combination with tacrolimus was superior to clobetasol-17 propionate (P = 0.048) with multivariate regression analysis.

Conclusion: We noted that 308-nm excimer lamp therapy was efficacious; adding topical tacrolimus or topical clobetasol-17 propionate could increase response to treatment.

Keywords: 308-nm excimer; clobetasol-17 propionate; digital morphometric analysis; tacrolimus; vitiligo.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Administration, Topical
  • Adult
  • Clobetasol / administration & dosage*
  • Female
  • Humans
  • Male
  • Photochemotherapy / instrumentation*
  • Photochemotherapy / methods
  • Retrospective Studies
  • Tacrolimus / administration & dosage*
  • Vitiligo / drug therapy*
  • Vitiligo / metabolism
  • Vitiligo / pathology

Substances

  • Clobetasol
  • Tacrolimus