Combination of fractional CO laser resurfacing and intradermal PRP was superior to CO laser alone for acne scar treatment.

IntroductionVitiligo is an idiopathic pigmentary disorder of the skin characterized by sharply demarcated asymptomatic depigmented macules. Its pathogenesis is still unclear. Many mechanisms and theories have been suggested including autoimmunity, auto cytotoxicity, biochemical and neuronal mechanisms. No universally effective nor curative medical or surgical treatment has been proposed till this day. First line treatments include topical treatments such as corticosteroids and calcineurin inhibitors. While surgical options such as autologous melanocytes transplantation are suggested later on. Phototherapy, including narrow band ultraviolet B (NB-UVB) and monochromatic excimer light (MEL) of wavelengths 311 nm and 308 nm respectively, is considered as a successful method of treatment among those approaches.2 The cytotoxic T-cells accountable for the destruction of melanocytes and disappearance of melanin are eliminated by phototherapy through apoptosis (diffuse repigmentation) and UVB does stimulate melanocytic proliferation and their migration to the epidermis from nearby follicular units (follicular repigmentation) and perilesional active melanocytes (marginal repigmentation).3 NB-UVB indoor cabins have been used to treat vitiligo since the early 1990s, but recently, MEL was used and adapted for the treatment of some dermatological diseases including vitiligo. 4 The 308 nm wavelength delivered by either laser/lamp has shown satisfactory superiority to broad band (BB-UVB) and NB-UVB for clinically treating vitiligo. 5Only few researchers studied histopathological changes before and after treatment with NB-UVB. 6 However, to the best of our knowledge, none compared the Recently, the monochromatic excimer light (MEL) of 308 nm wavelength has shown some advantages in comparison to narrow band ultraviolet B (NB-UVB) for the treatment of vitiligo. To histopathologically compare the early effects of NB-UVB and 308-nm MEL phototherapy on vitiliginous patches using H&E and HMB-45. Methods: Thirty subjects with non-segmental vitiligo lesions were treated twice a week for 6 weeks with 308-nm MEL, while NB-UVB was used to treat lesions contra laterally. Skin biopsies were taken from lesional areas before and after 6 weeks of treatment by either modality. It was prepared for light microscopy and immunohistochemical study . This study was performed as a clinical trial (Trial registration: http://www.pactr.org; Identifier: PACTR201705002279419) Results: All lesions before treatment had labeling index (number of pigmented cells/nonpigmented cells) of 0.0 (0%). After treatment the LI for MEL was 4.2 ± 2.6, while for NB-UVB LI it was 0.3 ± 0.7. MEL showed higher statistical significance regarding increase of basal pigmented cells, and significant decrease in vacuolated keratinocytes and basal membrane thickness than NB-UVB. Conclusion:Although NB-UVB is considered as treatment of choice for vitiligo, MEL is acknowledged as an effective treatment modality for vitiliginous lesions that induces more repigmentation than NB-UVB, and ...