Thesis (Ph.D.) - Cairo University - National Institute of Laser Enhanced Sciences - Department of Laser Application in Medical

Purpose: The aim of this study was to assess the efficacy of PRP versus combined Fr: CO2 with PRP in the treatment of stable non segmental vitiligo (NSV) lesions. Patients and methods: This prospective randomized intrapatient comparative controlled study was conducted between June 2014 and June 2016 at NILES "National Institute of Laser Enhanced Sciences" Cairo University, Cairo, Egypt. Thirty NSV patients were treated by PRP, Fr: CO2 laser and combined Fr: CO2 laser followed by PRP. Intrapatient lesions were divided randomly into four groups. Each group was treated by one modality. The fourth group served as control. Patients received six sessions with two weeks interval for 3 months and followed up after 3 months. Results: A highly significant reduction in the Vitiligo was demonstrated by Computer Assisted Grid "VACAG" in the group of combined Fr: CO2 laser followed by PRP and in the PRP only group than other groups. These results were confirmed by Mean Improvement Score by Physician (MIPS) and by Visual Analogue Scale (VAS) with no statistical difference between them. Fr: CO2 laser followed by PRP showed minimal side effects. Regardless of the modalities, better improvement was seen in the trunk than the face, extremities and acral lesions with significant reduction in all regions. Face showed maximum response with combined Fr: CO2 laser followed by PRP. Trunk showed uppermost response with PRP. Upper limbs showed highest response with combined Fr: CO2 laser + PRP. Lower limbs showed the highest improvement with Fr: CO2 laser. Conclusion: According to our study combined Fr: CO2 laser + PRP achieved superior re-pigmentation than intradermal (ID) PRP. However, Fr: CO2 alone came in the last rank. Combined ablative Fr: CO2 laser and PRP therapy followed by sun exposure could effectively and safely be used to treat refractory NSV

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