Monotherapy for vitiligo treatment using a 308-nm xenon-chloride excimer laser: colorimetry to assess the factor influencing the efficacy of this treatment in Asian patients
Monotherapy for vitiligo treatment using a 308-nm xenon-chloride excimer laser: colorimetry to assess the factor influencing the efficacy of this treatment in Asian patients
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使用 308 nm 氯化氙准分子激光单一疗法治疗白癜风：通过比色法评估影响亚洲患者治疗效果的因素
DOI：
10.1111/j.1346-8138.2012.01633.x
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发表时间：
2012
期刊：
影响因子：
3.1
通讯作者：
Akimichi Morita
中科院分区：
文献类型：
--
作者：
Reiko Noborio;Motoki Nakamura;Misako Yoshida;Reiko Nakamura;Rieko Ooshima;Ryoji Kubo;Hiroshi Kato ;Akimichi Morita
尊敬的编辑，准分子激光选择性地治疗一个小区域，而不会不必要地暴露正常皮肤的辐射。一些研究已经证实了准分子激光单药或联合治疗白癜风的疗效，但其对复发性白癜风的疗效尚不清楚。准分子激光是比窄带（NB）紫外线（UV）-B更有效的T细胞凋亡诱导剂，1并且许多细胞因子与黑素细胞中的黑素细胞迁移和DNA合成刺激相关。我们以前报道，内皮素-1，一种内在的黑素原或有丝分裂原的人黑素细胞在UV-B诱导的色素沉着，是更显着的受激准分子激光比其他UV-B光源。2在本研究中，我们评估了308 nm准分子激光单药治疗45例患者157处白癜风病变的疗效，治疗次数多达50次，这比以往研究中的治疗次数更多。此外，我们还评估了最小红斑剂量（MED）和皮肤颜色，并确定了对准分子激光治疗产生积极反应的因素。在进入研究前4周内，没有患者接受任何形式的光疗。病变分组：第1组，面颈部;第2组，肢端;第3组，其他。用308-nm氙-氯化物准分子激光（XTRAC Ultra Laser; Photomedex，San Diego，CA，USA）每周两次治疗白癜风贴片。治疗区域的色素沉着百分比评分为0-5，如下：0，0%; 1，1-5%; 2，6-25%; 3，26-50%; 4，51-75%;和5，76- 100%。终点为50次治疗或色素恢复评分为5分。初始治疗为1 MED。在该研究中，使用非侵入性比色法用比色计（CM-200; Konica Minolta，Osaka，Japan）测量白癜风斑块（直径> 8 mm）的皮肤颜色。在亚洲人的色度学研究中，黑色素指数与L*（亮度）值呈负相关，与a*（红度）和B*（暗度）值呈正相关。红斑指数与a* 值3呈正相关。对治疗病变中最大的斑进行皮肤颜色测量。对于治疗白癜风的皮肤颜色的测量，仅显示毛囊色素沉着的病例被省略。
Dear Editor, The excimer laser selectively treats a small area without unnecessarily exposing normal skin to radiation. Several studies have confirmed the efficacy of excimer laser monotherapy or combination therapy for vitiligo, but their efficacy for recalcitrant vitiligo is unclear. The excimer laser is a more potent inducer of T-cell apoptosis than narrowband (NB) ultraviolet (UV)-B, 1 and many cytokines are associated with melanocyte migration and DNA synthesis stimulation in melanocytes. We previously reported that endothelin-1, an intrinsic melanogen or mitogen for human melanocytes in UV-B-induced pigmentation, is induced more prominently by excimer laser than other UV-B light sources. 2 In the present study, we evaluated the efficacy of 308-nm excimer laser monotherapy in 45 patients with 157 vitiligo lesions for up to 50 treatment sessions, which is a greater number of treatments than that given in previous studies. In addition, we assessed the minimal erythema dose (MED) and skin color and determined the factors that contribute to a positive response to excimer laser treatment. None of the patients received any form of phototherapy in the 4 weeks before study entry. Lesions were grouped: group1, face and neck; group 2, acral; and group 3, other. Vitiligo patches were treated twice weekly with a 308-nm xenon-chloride excimer laser (XTRAC Ultra Laser; Photomedex, San Diego, CA, USA). Percentage of pigmentation of the treated areas was scored 0–5 as follows: 0, 0%; 1, 1–5%; 2, 6–25%; 3, 26–50%; 4, 51–75%; and 5, 76–100%. The end-point was 50 treatments or when the repigmentation score was 5. The initial treatment was 1 MED.In this study, the skin color of the vitiligo patch (> 8 mm in diameter) was measured using the non-invasive colorimetric method with a chromameter (CM-200; Konica Minolta, Osaka, Japan). In colorimetric study in Asians, the melanin index was correlated negatively with L*(lightness) value, and positively with a*(redness) and b*(darkness) values. The erythema index has a positive correlation with a* value3. Skin color measurement was performed on the largest macule in the treated lesions. For measurement of skin color of treated vitiligo, cases that showed only follicular pigmentation were omitted.