Excimer‐Laser bei Vitiligo – Kritische Wertung eigener retrospektiver Behandlungsergebnisse und Literaturübersicht

Abstract

Background: In numerous studies, the 308-nm-excimer-laser has been described as an effective therapy method for localized vitiligo.Our experience and critical evaluation of the relevant literature lead to a less enthusiastic endorsement. Patients and methods: A total of 9 patients with localized vitiligo were evaluated in our retrospective study. The sessions took place 2-3 times per week; the energy dose was increased depending on the occurring side effects.The rate of repigmentation was evaluated in 5 grades: grade 0 = 0%, grade 1 = 1-25 %, grade 2 = 26-50 %,grade 3 = 51-75 %,grade 4 = 76-100 %. Subjective patient satisfaction was rated satisfied/not satisfied Results: In face and neck areas, we used a cumulative energy dose of 16.6 J/cm 2 and achieved repigmentation grade 4 in 33.3 %, grade 2 in 33.3 %, grade 1 in 11.1 % and no improvement in 22.2 % of the cases. On hands and knees, we used a medium cumulative energy dose of 20.8 J/cm 2 and did not observe any tendency towards repigmentation. 4 of the patients were satisfied, while 5 were not. Side effects (erythema, blisters, crusting, and perilesional hyperpigmentation) were transient in all cases. Within a medium observation period of 19.1 months, one patient had a relapse. Conclusions: The excimer laser should be regarded as a treatment alternative in cases of localized vitiligo of the face.The treatment at other sites is clearly limited because of only partial repigmentation, considerable expense of time and money and not least the potentially higher risk of tumorigenesis.