Efficacy of fractional carbon dioxide laser and platelet rich plasma versus fractional carbon dioxide laser alone in patients of vitiligo

Authors

  • Fatima Bashir AMC/ PGMI/ Lahore General Hospital, Lahore
  • Ghazia Shaheen AMC/PGMI/Lahore General Hospital, Lahore
  • Kehkshan Tahir Fatima Jinnah Medical University/ Sir Ganga Ram Hospital, Lahore
  • Uzma Amin SIMS/ Services Hospital, Lahore
  • Anum Naveed AMC/ PGMI/ Lahore General Hospital, Lahore
  • Memoona Tahir AMC/ PGMI/ Lahore General Hospital, Lahore

Keywords:

Fractional Carbon Dioxide (FCO2), Platelet Rich Plasma (PRP), Vitiligo, VASI

Abstract

Background Vitiligo is an acquired pigmentary disorder caused by loss of epidermal melanocytes. Several treatments using laser and surgical techniques provide hope for patients with vitiligo who have not shown re-pigmentation with traditional therapies. Fractional CO2 lasers and PRP are latest advances in non-surgical skin rejuvenation treatments.   Objective To compare the efficacy of fractional carbon dioxide laser and platelet rich plasma versus fractional carbon dioxide laser alone in patients of vitiligo.   Methods After meeting the inclusion criteria, 60 patients (30 in each group) were randomly allocated by lottery method.  Group A received sessions of fractional CO2 laser + PRP at three weeks interval and group B received only fractional CO2 laser at three weeks interval for total three months. VASI score was calculated at baseline and three weeks after end of treatment. Efficacy was assessed by calculating decrease of VASI score from baseline till three weeks after end of treatment and >50% reduction in VASI score from baseline was termed as efficacious.   Results Mean age of patients was 33.58±11.75 years. There were 34 (56.67%) male and 26 (43.3%) female patients. In group A, efficacy was achieved in 17 (56.7%) patients and in group B, efficacy was achieved in 7 (23.3%) patients (p-value=0.008).   Conclusion Results of our study concluded that fractional CO2 laser combined with PRP has statistically significant better efficacy than fractional CO2 laser alone in treating vitiligo.  

Author Biographies

Fatima Bashir, AMC/ PGMI/ Lahore General Hospital, Lahore

Department of Dermatology

Ghazia Shaheen, AMC/PGMI/Lahore General Hospital, Lahore

Department of Dermatology

Kehkshan Tahir, Fatima Jinnah Medical University/ Sir Ganga Ram Hospital, Lahore

Associate Professor Department of Dermatology

Uzma Amin, SIMS/ Services Hospital, Lahore

Department of Dermatology

Anum Naveed, AMC/ PGMI/ Lahore General Hospital, Lahore

Department of Dermatology

Memoona Tahir, AMC/ PGMI/ Lahore General Hospital, Lahore

Department of Dermatology

References

Arora AK, Kumaran MS. Pathogenesis of vitiligo: An update. Pigment Int. 2017;4(2):65.

Rashighi M, Harris JE. Vitiligo pathogenesis and emerging treatments. Dermatol Clinics. 2017;35(2):257-65.

Zhang Y, Cai Y, Shi M, Jiang S, Cui S, Wu Y, et al. The prevalence of vitiligo: a meta-analysis. PloS One. 2016;11(9):e0163806.

Zahoor M, Shaukat S, Khan MS, Ahmad TJ. Comparison of efficacy and safety of 0.005% calcipotriol ointment versus 0.05% betamethasone dipropionate ointment versus calcipotriol plus betamethasone ointment for the treatment of vitiligo. J Pak Assoc Dermatol. 2017;27(1):30-6.

Bolognia JL, Pawelek JM. Biology of hypopigmentation. J Am Acad Dermatol. 1988;19(2):217-55.

Kadry M, Tawfik A, Abdallah N, Badawi A, Shokeir H. Platelet-rich plasma versus combined fractional carbon dioxide laser with platelet-rich plasma in the treatment of vitiligo: a comparative study. Clin Cosmet Inves Dermatol. 2018;11:551.

Mahajan R, Ninama K, Shah H, Bilimoria F. Effect of intralesional platelet rich plasma in chronic localized vitiligo. Int J Res Dermatol. 2018;4(4):550-5.

Abdelghani R, Ahmed NA, Darwish HM. Combined treatment with fractional carbon dioxide laser, autologous platelet‐rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: a prospective, randomized comparative trial. J Cosmet Dermatol. 2018;17(3):365-72.

Li L, Wu Y, Li L, Sun Y, Qiu L, Gao XH, et al. Triple combination treatment with fractional CO2 laser plus topical betamethasone solution and narrowband ultraviolet B for refractory vitiligo: a prospective, randomized half‐body, comparative study. Dermatol Ther. 2015;28(3):131-4.

Ho A, Sukhdeo K, Sicco KL, Shapiro J. Trichologic response of platelet-rich plasma in androgenetic alopecia is maintained during combination therapy. J Am Acad Dermatol. 2020;82(2):478-9.

Khattab FM, Abdelbary E, Fawzi M. Evaluation of combined excimer laser and platelet‐rich plasma for the treatment of nonsegmental vitiligo: A prospective comparative study. J Cosmet Dermatol. 2020;19(4):869-77.

Ibrahim ZA, El‐Ashmawy AA, El‐Tatawy RA, Sallam FA. The effect of platelet‐rich plasma on the outcome of short‐term narrowband– ultraviolet B phototherapy in the treatment of vitiligo: a pilot study. J Cosmet Dermatol. 2016;15(2):108-16.

Awad SS. Dermabrasion may repigment vitiligo through stimulation of melanocyte precursors and elimination of hyperkeratosis. J Cosmet Dermatol. 2012;11(4):318-22.

Wu CS, Yu CL, Wu CS, Lan CCE, Yu HS. Narrow‐band ultraviolet‐B stimulates proliferation and migration of cultured melanocytes. Exp Dermatol. 2004;13(12):755-63.

Faghihi G, Keyvan S, Asilian A, Nouraei S, Behfar S, Nilforoushzadeh M. Efficacy of autologous platelet-rich plasma combined with fractional ablative carbon dioxide resurfacing laser in treatment of facial atrophic acne scars: A split-face randomized clinical trial. Indian J Dermatol Venereol Leprol. 2016;82(2):162-8.

Raizada A, Panda M, Singh BS, Kar BR. Fractional carbon dioxide laser versus fractional carbon dioxide laser with autologous intralesional platelet-rich plasma in the treatment of stable, non-segmental vitiligo: A randomized comparative study. J Cut Aesthet Surg. 2021;14(1):55.

Do JE, Shin JY, Kim DY, Hann SK, Oh SH. The effect of 308 nm excimer laser on segmental vitiligo: a retrospective study of 80 patients with segmental vitiligo. Photoderm Photoimmunol Photomed. 2011;27(3):147-51.

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Published

2024-05-06

How to Cite

1.
Fatima Bashir, Ghazia Shaheen, Kehkshan Tahir, Uzma Amin, Anum Naveed, Memoona Tahir. Efficacy of fractional carbon dioxide laser and platelet rich plasma versus fractional carbon dioxide laser alone in patients of vitiligo. J Pak Assoc Dermatol [Internet]. 2024May6 [cited 2024Nov.2];34(1):123-9. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/2621

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