Evaluation of fractional carbon dioxide laser-assisted drug delivery of calcipotriol plus betamethasone versus bimatoprost in the treatment of vitiligo

Abstract

Introduction Vitiligo is a disease in which melanocytes (pigment-producing cells) are damaged or destroyed resulting in a patchy loss of pigment from areas of skin. Vitiligo patches can appear anywhere on the skin, but commonly affected sites include the areas around the orifices, the genitals, or any sun-exposed areas such as the face and the hands. The hair and, rarely, the eyes may also be affected. Aim The aim of the work is to evaluate the efficacy of transepidermal drug delivery by CO2 fractional laser of calcipotriol plus betamethasone versus bimatoprost in the treatment of vitiligo. Patients and methods This study included 20 patients with vitiligo. The patients were selected from the Outpatient Clink of Dermatology and Venereology Department in Al-Hussien University Hospital from March 2019 to September 2019. Results Comparison between the first and the second patches was done. In each patient, two patches were selected and classified as follows: side A is the right side, and it was treated with fractional CO2 laser followed by topical bimatoprost (0.03%) drops, and side B is the left side, and it was treated with fractional CO2 laser followed by topical calcipotriol (0.05 mg/g) plus betamethasone (0.5 mg) ointment. The repigmentation grade showed a statistically significant increase in the second patch: regarding the right side, there were five (25%) patients of grade 0, 10 (50%) patients of grade I, three (15%) patients of grade II, one (5%) patient of grade III, and one (5%) patient of grade IV (the mean response was 21±23.7, with minimum response of 0 and maximum response of 80). Regarding the left side, there were three (15%) patients of grade 0, nine (45%) patients of grade I, three (15%) patients of grade II, one (5%) patient of grade III, and four (20%) patients of grade IV (the mean response was 34.8±30.1, with minimum response of 0 and maximum response of 90). Conclusion From the result of this study, we can conclude that fractional CO2 laser followed by topical calcipotriol (0.05 mg/g) plus betamethasone (0.5 mg) ointment gives better results than fractional CO2 laser followed by topical bimatoprost (0.03%) drops in the treatment of vitiligo.