A comparative clinical trial to evaluate efficacy and safety of the 308‐nm excimer laser and the gain‐switched 311‐nm titanium:sapphire laser in the treatment of vitiligo

Abstract

Background/purpose Ultraviolet B (UVB) laser irradiation in a targeted manner is a reasonable treatment option for localized vitiligo. Recently, narrow‐band UVB gain‐switched 311‐nm titanium:sapphire lasers (TSL) were developed for the treatment of localized vitiligo. We aimed to compare efficacy, patient satisfaction, and safety between the conventional 308‐nm excimer laser (EL) and gain‐switched 311‐nm TSL in patients with vitiligo. Methods The 13‐paired lesions from 10 patients who had small vitiligo patches were included in this prospective intra‐patient comparison trial. Each pair was randomly assigned to each laser treatment group and treated twice weekly for 12 weeks. The global photographic assessments by dermatologists, objective numerical assessments by imaging analyzer, and patient's satisfaction were used to evaluate the effectiveness. Adverse effects were also investigated at every visit. Results All treated lesions showed improvement of about 50% after 12 weeks. There was no significant difference between EL‐ and TSL‐treated groups. Patient satisfaction and preference among the groups were also similar. Regarding safety, there were no serious adverse effects requiring cessation of the treatments; however, the severity score for persistent erythema (lasting >24 hours) was significantly lower in the TSL group than in the EL group. Conclusions The gain‐switched 311‐nm TSL exhibited similar efficacy to the 308‐nm EL in treating vitiligo as well as improved safety. Therefore, the 311‐nm TSL is considered as a candidate device to replace the EL as a new and promising treatment option for localized vitiligo.

Bridging Molecular Mechanism and Clinical Practice in Vitiligo Treatment: An Updated Review

“…Unlike EL therapy, TSL requires no periodic gas charging because a solid laser medium is employed. TSL has shown a comparable efficacy to that of the EL and exhibited good safety profiles in several clinical studies [41, 42]. Owing to the shared wavelength, the therapeutic mechanism of TSL in vitiligo may be similar to that of NBUVB and EL [41] modulating immune cells and increasing melanogenesis, which has been further supported by the increased levels of melanogenic cytokines, including endothelin-1, SCF, and Wnt7a after TSL irradiation [41].…”