Pilot Study on the Use of the “Monocyte-Rich” Platelet-Rich Plasma in Combination with 1927 nm Fractional and 308 nm Excimer Lasers for the Treatment of Vitiligo

Abstract

Background and objectives: Vitiligo is an acquired chronic and idiopathic skin disorder, characterized by selective loss of melanocytes and resulting in a cutaneous depigmentation. Treatment for vitiligo remains a challenge for dermatologists; thus, it is frustrating both for physicians and patients. The objective of this study was to evaluate a combination treatment characterized by the use of a leukocyte-rich platelet-rich plasma, which is particularly rich in monocytes (defined here as monocyte-rich PRP), in combination with a 1927 nm fraxel laser and a 308 nm excimer laser. Materials and Methods: Treatment with monocyte-rich PRP combined with 1927 nm fraxel laser and 308 nm excimer laser was performed in nine sessions in 80 days and the median follow-up of the patients was 10 months. A total of 27 Caucasian patients were included in the present study. The median age of patients was 41 years, ranging between 20 and 69 years. Results: A re-pigmentation occurred in 16 cases (59%) with a reduction of the Vitiligo Extent Score (VES) and absence of re-pigmentation in untreated areas. Performing a rank correlation between VES and re-pigmentation in the treated areas, we found that there was a significant correlation (p < 0.0001). The presence of progressive vitiligo (p = 0.1) and the anatomic areas (p = 0.1) did not influence the treatment. Untreated areas did not show any improvement of the depigmented lesions, except in one case (p < 0.0001). Conclusions: in this report, we show for the first time how PRP rich in monocytes, in combination with laser therapies, gives a long therapeutic response, which persists even after 10 months of follow-up.

The value of adding platelet‐rich plasma (PRP) to noncultured epidermal cell suspension (NCECS) in surgical treatment of stable resistant vitiligo: A self‐controlled randomised double‐blinded study

“…Platelet-rich plasma has been reported as a valuable adjuvant tool to narrowband UVB phototherapy, excimer laser and fractional laser in treatment of vitiligo [5][6][7][8] and vitiligo surgery. [9][10][11] However, the value of PRP in treatment of knowingly resistant sites has not been adequately evaluated.…”

“…3 There are different types of platelet-rich plasma (PRP) including pure platelet-rich plasma (P-PRP), leukocyte and platelet-rich plasma (L-PRP), pure platelet-rich fibrin and leukocyte and platelet-rich fibrin (L-PRF). 4 Plateletrich plasma has been reported to enhance the repigmentation response of different therapeutic modalities for vitiligo, including narrowband UVB phototherapy, excimer laser and fractional laser [5][6][7][8] as well as vitiligo surgery via enhancing melanocyte proliferation and boosting hair growth and hair melanocyte reservoir. [9][10][11] Platelet-rich plasma offers further advantages in vitiligo surgery as it contains trypsin inhibitor, which can enhance melanocyte survival.…”

“…11 Most of the studies applied pure PRP [5][6][7][9][10][11] ; however, monocyte-rich PRP has been recently suggested as a valuable adjuvant tool. 8 Excimer lasers (308 nm) and excimer lamps allow targeted phototherapy at high intensity, together with enabling the treatment of small, inaccessible or resistant areas with more rapid response when compared to ordinary phototherapies. 12 In the light of these facts, we conducted this study to evaluate the role of suspending noncultured epidermal cell suspension (NCECS) in PRP in surgical treatment of such resistant areas.…”

Comparison of the efficacy and safety of 308‐nm excimer laser as monotherapy and combination therapy with topical tacrolimus in the treatment of periocular vitiligo

“…32 PRP contains growth factors, chemokines, cytokines and other plasma proteins that inhibit local inflammatory responses and promote melanocyte regeneration. 33 Khattab et al 34 and Mercuri et al 35 demonstrated that PRP combined with 308-nm EL is feasible for vitiligo. So far, there is no single treatment that completely cures vitiligo, so we hope to have more novel combination therapies, such as PRP in combination with 308-nm EL, available for clinicians and patients to choose from in the future.…”

Prevention and Treatment of Chemotherapy-Induced Alopecia: What Is Available and What Is Coming?

“…Additionally, platelets can also release numerous anti-inflammatory cytokines such as interleukin-1 receptor antagonist (IL-1ra), soluble tumor necrosis factor (TNF) receptor (sTNF-R) I, interleukin (IL)-4, IL-10, IL-13, and interferon γ [ 73 ]. PRP has been used as an autologous injection for various medical conditions to promote healing and tissue regeneration/rejuvenation [ 73 , 74 , 75 , 76 , 77 , 78 ]. Additionally, PRP has also been used widely in alopecia treatment due to its ability to induce cell proliferation, supporting HF growth, and extending anagen [ 72 , 79 , 80 , 81 , 82 ].…”