Thesis (Ph.D.) - Cairo University - National Institute of Laser Enhanced Sciences - Department of Laser Applications in medical & biological

Background: Vitiligo is an acquired disease with a variable course characterized clinically by well defined depigmented macules or patches thought to occur secondary to melanocyte dysfunction and loss Aim of work: To compare the efficacy of topical 5-FU as monotherapy to combined therapy of topical 5-FU and Er:YAG (2940 nm) laser in the treatment of non-segmental vitiligo (NSV). Patients and Methods: This is a prospective randomized comparative intrapatient study. Thirty patients diagnosed with NSV were recruited from the dermatology outpatient clinics of the Medical Research Centre of Excellence, the National Research Centre and the National Institute of Laser Enhanced Sciences. Our study group was divided into two subgroups, Group 1 was subjected to ablative Er:YAG and 5-FU cream and Group 2 applied topical 5-FU cream. Three treatment sessions were repeated every 4 to 6 weeks and patients were followed up to 9 months. Repigmentation was assessed by digital photography and subsequent computer based image analysis.Results: Repigmentation of Group 1 patients ranged from 0 to 70% (mean 12±7%) whilst in Group 2 it ranged from 0 to 5% (mean 1.4±0.8%). Both groups showed repigmentation in 25/30 (83.3%) on assessment by image analysis .22/30(73.3%) showed mild to moderate repigmentation and in 3/30 (10%) repigmentation was marked. It started in all patients after 3months and persisted or increased during a period of follow up to 9 months .Groups 1 and 2 were subdivided into A and B, vitiligo involving non-resistant and resistant areas respectively. Group 1A showed more repigmentation (mean 13.8±8.5%) than Group 1B (mean 9.8±4.5%) and Group 2Ashowed more repigmentation (mean 1.5±1%) than Group 2B (mean 1.3±0.5%).

Issued also as CD