308nm准分子激光治疗白癜风的疗效评价及患者生活质量评估

目的评价308 nm准分子激光治疗白癜风的临床疗效及安全性。评估308 nm准分子激光治疗对白癜风患者生活质量的影响。方法采用308 nm准分子激光治疗68例白癜风患者,共162片皮损,每周治疗2次,共12~30次,治疗结束后评价临床疗效及安全性。在治疗前后用中文版皮肤病生活质量指数(Dermatology life quality index,DLQI)量表进行问卷调查,评估308 nm准分子激光治疗对白癜风患者生活质量的影响。结果经308 nm准分子激光治疗,皮损的总有效率为80.86%,平均照射5.21次开始出现色素点,面颈部及躯干部的疗效显著,主要不良反应为瘙痒与干燥。治疗后随着色素恢复,皮损面积明显缩小,DLQI评分显著降低,且与色素恢复情况显著负相关。结论 308nm准分子激光治疗白癜风疗效显著、见效快、不良反应少。其在改善皮损的同时能有效提高白癜风患者的生活质量。     

308nm准分子激光治疗稳定期白癜风临床观察

目的观察308nm准分子激光治疗稳定期白癜风的临床疗效。方法选择79例稳定期白癜风患者皮损358片进行治疗,治疗次数10~30次。结果有效率为42.74%。头面部及躯干部位效果好,肢端及骨性突出部位效果差,寻常型和节段型皮损同样有效,增加治疗次数可以改善治疗效果。结论308nm准分子激光治疗稳定期白癜风安全有效,局限性皮损及紫外线敏感区域皮损是其主要适应证。     

308 nm准分子激光治疗白癜风疗效与影响因素分析

目的:评价308 nm准分子激光治疗白癜风的疗效及其影响因素。方法:采用308 nm准分子激光系统治疗103例白癜风患者171处皮损,每周治疗1～2次,共12～50次,治疗结束后评价疗效。结果:皮损的总显效率为59.06%,有效率为83.04%。疗效影响因素分析显示不同部位、年龄、病程以及皮损大小对治疗效果有显著影响。结论:308 nm准分子激光治疗白癜风疗效高、副作用少。     

308 nm准分子激光治疗白癜风的研究进展

白癜风是一种难治的疾病。随着308 nm准分子激光作为一种新型光源在治疗银屑病中取得显著成效,也渐渐被用来治疗白癜风,且已得到患者及临床医师的认可。本文对308 nm准分子激光治疗白癜风的研究进展综述如下。     

308 nm 准分子激光联合胸腺肽胶囊治疗白癜风疗效观察

应用308 nm准分子激光治疗白癜风已有报道[1-2],疗效确切.我们使用308 nm准分子激光联合口服胸腺肽胶囊治疗稳定期白癜风患者,并与单独口服胸腺肽胶囊者进行对比,现报道如下.     

308nm准分子激光联合CO_2点阵激光治疗白癜风45例临床观察

目的探讨308nm准分子激光联合CO_2点阵激光治疗白癜风的临床疗效和安全性。方法选择临近或对称部位有两独立皮损的稳定期白癜风患者45例,将每例患者的两独立皮损随机分为两组,治疗组予308nm准分子激光治疗,同时定期予CO_2点阵激光治疗,对照组仅予308nm准分子激光治疗,治疗20次后评价临床疗效。结果治疗组总有效率为97.78%(44/45),有效率为48.89%(22/45),对照组总有效率为82.22%(37/45),有效率为26.67%(12/45),两组皮损的总有效率和有效率差异均有统计学意义(P均0.05)。所有皮损治疗中均未出现严重不良反应。结论 308nm准分子激光联合CO_2点阵激光治疗白癜风疗效好,安全性高,值得临床医生选择。     

CO2点阵激光联合308 nm准分子激光治疗白癜风疗效和安全性meta分析

目的：评价CO₂点阵激光联合308 nm准分子激光治疗白癜风的临床疗效和安全性。方法：通过检索Cochrane Library、PubMed、Embase、万方、中国知网、维普数据库,收集CO₂点阵激光与308 nm准分子激光联合治疗白癜风相关的文献,运用软件（Revman 5.3）进行Meta分析。结果：13篇临床随机对照实验被纳入,其中1014处皮损给予CO₂点阵激光与308 nm准分子激光联合治疗,1005处皮损给予308 nm准分子激光单独治疗。结果显示：联合疗法总有效率和显效率优于单用308 nm准分子激光;两组不良反应发生率无明显差异。结论： CO₂点阵激光+308 nm准分子激光联合治疗白癜风的疗效优于单独使用308 nm准分子激光,且两种疗法的不良反应没有明显差异。     

他克莫司软膏联合308 nm准分子激光治疗白癜风临床疗效观察

目的：评价0．1％和0．03％他克莫司软膏联合308nm准分子激光治疗对紫外线治疗抵抗的白癜风皮损的疗效与安全性。方法：采用随机、自身对照的临床试验，每例患者选取紫外线治疗抵抗区域的皮损，随机选取躯体一侧皮损为治疗侧，采用他克莫司软膏联合308nm准分子激光治疗；另一侧为对照侧，仅用308nm准分子激光治疗。2个月后进行疗效判定。结果：联合治疗组有效率为89．0％，对照组为71．6％，两组间疗效比较差异有统计学意义（P〈0．05）。结论：他克莫司软膏联合308nm准分子激光治疗白癜风起效快，疗效好。     

中药滋补肝肾方联合308nm准分子激光治疗寻常型白癜风的临床观察

目的观察中药滋补肝肾方联合308 nm准分子激光治疗寻常型白癜风肝肾不足证的临床疗效。方法共选取90例白癜风患者,按照随机数字表分为2组,试验组和对照组分别45例。两组均采用308准分子激光治疗,试验组加用中药滋补肝肾方口服治疗,两组疗程均为12周,对比2种治疗方案的临床疗效。结果试验组和对照组有效率分别为93.33%和68.89%,两组比较,差异有统计学意义(P0.05)。结论中药滋补肝肾方联合308 nm准分子激光治疗白癜风临床疗效显著,值得临床推广。     

308 nm准分子激光联合富血小板血浆治疗白癜风有效性与安全性Meta分析

目的：比较308 nm准分子激光联合富血小板血浆(platelet-rich plasma, PRP)与单用308 nm准分子激光治疗白癜风的有效性与安全性。方法：检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库中关于308 nm准分子激光联合PRP治疗白癜风的研究,并对文献进行筛选及数据提取。以有效率、显效率作为疗效指标进行统计分析,计算OR及相应的95% CI值。结果：本文共纳入4篇研究,统计分析显示,308 nm准分子激光联合PRP与单用308 nm准分子激光比较有效率：OR=3.39,95% CI 1.98~5.80;显效率：OR=10.31,95% CI 2.43~43.72。两种疗法均无严重不良反应发生。结论：308 nm准分子激光联合PRP治疗白癜风疗效优于单用308 nm准分子激光。     

Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311–313 nm) in the treatment of vitiligo – a multicentre controlled study

BACKGROUND: Vitiligo is an acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of epidermal melanocytes. Recently, it has been shown that narrowband ultraviolet B (NB-UVB) phototherapy may be more effective than psoralen and ultraviolet A (PUVA) photochemotherapy in treating vitiligo, and that 308-nm monochromatic excimer light (MEL) may present some advantages as compared to NB-UVB for the treatment of vitiligo. AIM The aim of this study was to compare the effectiveness of NB-UVB phototherapy and 308-nm MEL in vitiligo patients. METHODS: The study was done in a randomized, investigator-blinded and half-side comparison design. Twenty-one subjects with symmetrical vitiligo lesions were enrolled in this study. Vitiligo lesions on one body side were treated twice weekly for 6 months with 308-nm MEL, while NB-UVB phototherapy was used to treat lesions on the opposite side. RESULTS: At the end of the study six lesions (37.5%) treated with 308-nm MEL and only one lesion (6%) treated with NB-UVB achieved an excellent repigmentation (score 4) while four lesions (25%) treated with 308-nm MEL and five lesions (31%) treated with NB-UVB showed a good repigmentation (score 3). CONCLUSIONS: It appears that 308-nm MEL is more effective than NB-UVB in treating vitiligo lesions and it induces repigmentation more rapidly.     

Monochromatic excimer light 308 nm in the treatment of vitiligo: a pilot study

OBJECTIVE: To study the efficacy and safety of monochromatic excimer light (MEL) on 37 vitiligo patients referred to our clinic. METHODS: In a pilot study, 37 patients (17 males, 20 females) with acrofacial (n=21), focal (n=11), segmental (n=1), and generalized (n=4) vitiligo were treated twice weekly with MEL for a maximum period of 6 months. RESULTS: Thirty-five patients (95%) showed signs of repigmentation within the first eight treatments. The treatment resulted in good repigmentation in 16 patients, and excellent repigmentation in 18 patients. Adverse events were limited to transient erythema. In addition, some patients (n=3) not responding to prior narrow-band UVB (NB UVB) phototherapy showed good results with MEL in our series. CONCLUSIONS: Treatment with 308 nm MEL for vitiligo may be more effective in obtaining rapid repigmentation than phototherapy with NB UVB. The results in this study are similar to those recently reported with a 308 nm excimer laser, but 308 MEL could present some advantages: the possibility of treating larger areas compared to the 308 nm excimer laser, with shorter treatment times and better patient compliance. The overall good results and the early appearance of repigmentation contribute to reducing the cumulative exposure to UV radiation.     

单频准分子光治疗白癜风的临床研究

目的 研究观察单频准分子光308nm局部照射治疗白癜风的临床疗效,评估其安全性.方法 对77例不同临床类型的白癜风患者的201处皮损进行局部照射,每周1次,随访3-6个月.结果 经过准分子光局部照射平均18次,86.6%皮损有不同程度色素恢复,色素恢复随疗程延长而增加,照射24次总有效率为71.0%,显效率为51.6%.躯干、颈部和头面部疗效优于四肢及手足;泛发型和节段型白癜风疗效尤佳.主要不良反应为局部水疱和疼痛,患者能耐受.结论 准分子光局部照射治疗白癜风疗效显著,且不良反应少.     

A review of monochromatic excimer light in vitiligo

Phototherapy is a mainstay of vitiligo treatment and has varying rates of efficacy. Narrowband ultraviolet (UV) B (NB‐UVB) and UVA have been used for decades, but it is only recently that monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. The specific 308‐nm radiation wavelength is delivered in a targeted form by the xenon‐chloride excimer laser and is also available in an incoherent form that is commonly referred to as the excimer lamp. MEL administered by both laser and lamp has shown efficacy superior to NB‐UVB for the treatment of vitiligo and induces more changes at the cellular level than conventional UVB modalities. The excimer laser is effective in adults and children with vitiligo in all skin types as monotherapy or in combination with other established vitiligo therapeutics. Treatment regimens studied included excimer laser two to three times weekly for up to 36 weeks. Patients commonly achieved > 75% repigmentation. The laser has also been used in combination with topical corticosteroids, calcineurin inhibitors and vitamin D analogues, as well as surgery, thus further expanding treatment options for patients with vitiligo. The excimer lamp has been used for treatments one to three times a week for up to 24 weeks and was found to be equal to excimer laser in a head‐to‐head comparison. It has also been used in combination with topical corticosteroids and oral vitamin E. Both MEL modalities have a limited adverse side‐effect profile. Long‐term effects are yet to be determined; however, based on available data on UVB phototherapy as well as the properties of MEL devices, there is probably only a minimal increased malignancy risk.     

Treatment of vitiligo with the 308-nm excimer laser: a pilot study

BACKGROUND: Present vitiligo therapies require many months of treatment and often result in disappointing outcomes. Common therapeutic options include phototherapy with psoralens plus ultraviolet A (UVA) radiation and broadband or narrowband UVB radiation phototherapy. Some of these modalities require regular phototherapy sessions several times a week for up to a year to achieve a therapeutic response. Targeted phototherapy with single-wavelength laser light is a treatment alternative that may prove to be a time-efficient and effective therapeutic option for the management of vitiligo. METHODS: This intervention study was designed as a before and after trial with a single arm. Twenty-nine patches of vitiligo from 18 patients (6 males and 12 females) were treated at the start of the study. Vitiligo patches were treated by using a 308-nm xenon-chloride excimer laser. Lesions were treated 3 times a week for a maximum of 12 treatments. Treatment was withheld if sunburn was observed and held until resolution. All patients had untreated vitiligo patches that served as control sites. RESULTS: Twenty-three vitiligo patches from 12 patients received at least 6 treatments and resulted in some repigmentation in 57% of the treated patches. Eleven vitiligo patches from 6 patients received all 12 treatments and resulted in some repigmentation in 82% of the treated patches. Untreated control patches remained unchanged. CONCLUSION: This degree of repigmentation in a period of 2 to 4 weeks is much higher than that achieved with any other present vitiligo therapy. The xenon-chloride excimer laser may represent a new treatment modality for the management of stable vitiligo.     

Monochromatic excimer light 308 nm in monotherapy and combined with topical khellin 4% in the treatment of vitiligo: a controlled study

Vitiligo is an acquired depigmentation disorder affecting 1–4% of the world's population. Conventional therapies include steroids, photosensitive topical agents, surgical treatments, and phototherapy. The aim of the study was to evaluate the efficacy of monochromatic excimer light 308 nm (MEL), both as a monotherapy and in combination with khellin 4% ointment in vitiligo. Forty-height patients (36 male and 12 female) affected with vitiligo were enrolled in this open prospective study. Patients were selected and divided into three groups: group I included 16 patients treated with MEL 308 nm once-weekly and oral vitamin E; group II included 16 patients treated with MEL 308 nm once-weekly combined with khellin 4% ointment (MEL-K) and oral vitamin E; group III (control group) included 16 patients treated only with oral vitamin E. Efficacy was assessed at the end of 12 weeks based on the percentage of repigmentation. Group I (MEL-group) showed a moderate repigmentation in 2/16 (12.5%) patients, good repigmentation in 10/16 (62.5%), and excellent repigmentation in 4/16 (25%) patients. Group II (MEL-K group) presented moderate repigmentation in 2/16 (12.5%) patients, good repigmentation in 5/16 (31.25%), and excellent repigmentation in 9/16 (56.25%). Group III (control group) showed a moderate repigmentation in 3/16 patients (18.75%), a good repigmentation in 1/16 (6.25%) patient, while 10/16 (62.5%) patients did not show signs of repigmentation. The clinical response achieved in group I and II was higher compared with group III (control group) without showing significant differences. MEL 308 nm, alone and/or combined with khellin 4% offered encouraging results and it may be considered a valid therapeutic option worthy of consideration in the treatment of vitiligo.     

Phototherapy for the Treatment of Vitiligo in Asian Children

Vitiligo is a common acquired progressive depigmenting condition that can have devastating psychological effects in dark‐skinned patients. We performed a retrospective review of patients younger than 16 years of age with a clinical diagnosis of vitiligo treated using phototherapy at the National Skin Center, Singapore, over a 5‐year period. Seventy‐one Asian patients ages 5 to 15 years when they underwent phototherapy were identified. There was a higher proportion of Indian patients in our cohort than in the population. The duration of disease ranged from 2 months to 12 years. More than half of the patients had generalized vitiligo and more than one‐third had segmental vitiligo. Patients with generalized vitiligo had a better response than those with segmental vitiligo. Reported response rates were highest for narrowband ultraviolet B (UVB) phototherapy, followed by targeted phototherapy combining ultraviolet A1 (UVA1) and UVB; 308‐nm excimer lamp phototherapy and paint psoralen–UVA photochemotherapy had marginally lower reported response rates. The duration of treatment ranged from 3 to 40 months and the total number of treatments ranged from 20 to 209 sessions. Reported side effects were mild and included itching, scaling, erythema, pain, sunburn, blistering, and phototoxicity. We consider phototherapy to be a safe and efficacious modality for the treatment of vitiligo in Asian children.     

Phototherapy with narrowband vs broadband UVB

Phototherapy with ultraviolet (UV) radiation of wavelengths between 280 and 320 nm (UVB) is a safe and effective treatment for a variety of diseases. In addition to standard broadband UVB (bUVB), narrowband phototherapy with fluorescent bulbs emitting near monochromatic UV around 311 nm (nUVB) has become an important treatment for diseases such as psoriasis, atopic dermatitis and vitiligo. In addition to these indications, the number of diseases for which nUVB phototherapy is reported to be effective is continuously growing. The differential effects of nUVB phototherapy in comparison to other UV wavelengths as well as established and new indications for this treatment modality are reviewed.     

Photo(chemo)therapy for vitiligo

Vitiligo is a common skin disease characterized by loss of normal melanin pigments in the skin and its pathogenesis is still unclear. Treatment modalities include psoralen plus ultraviolet A, narrow-band ultraviolet B (NB UVB) phototherapy, topical and systemic steroids, topical calcineurin inhibitors, topical vitamin D analogues in monotherapy or in association with phototherapy, and surgical treatment. NB UVB (310-315 nm) radiation is now considered as the 'gold standard' for the treatment of diffuse vitiligo, and treatment with two recently introduced UVB sources that emit 308 nm wavelengths, the 308 nm xenon chloride (XeCl) excimer laser and the 308 nm XeCl excimer light, has also been reported to be effective and might be the treatment of choice for localized disease: this treatment modality has been defined as 'targeted phototherapy.'     

窄谱UVB和宽谱UVB的光疗比较

波长280—320nm的紫外线辐射光疗对于许多疾病是安全有效的治疗。除了标准的宽谱中波紫外线外，用发射311nm几乎单色紫外线的荧光灯进行的窄谱光疗已经成为一些疾病的重要治疗措施，如银屑病、特应性皮炎和白癜风等。除了这些适应证外，窄谱中波紫外线光疗报道有效的疾病数量正在增多。