Rapid response of facial vitiligo to 308nm excimer laser and topical calcipotriene.

OBJECTIVE: Vitiligo is a common depigmenting condition that carries a high psychosocial morbidity. Many of the current topical and light therapies aid in repigmentation but require extensive treatment periods and carry unwanted side effects. The excimer laser is a newer treatment option that can induce repigmentation in an abbreviated time frame without global exposure to radiation. This case series provides further evidence to support the use of excimer laser in treating vitiligo especially of the face.

DESIGN: Patients with extensive facial depigmentation were treated with excimer laser twice weekly and calcipotriene daily until they developed significant repigmentation.

SETTING: Evaluation and treatment was performed at the Veterans Affairs outpatient dermatology clinic in Tampa, Florida.

PARTICIPANTS: Three patients with Fitzpatrick skin types IV to VI were selected. These patients had failed a variety of topical treatments including steroids and calcipotriene, but were light naïve prior to beginning the study.

MEASUREMENTS: The primary outcome measure employed was percent repigmentation by visual estimation. The average dose of radiation, number of treatments, and weeks of therapy were also recorded.

RESULTS: All three patients experienced greater than 75 percent repigmentation of their facial vitiligo over a treatment course from 10 to 20 weeks.

CONCLUSION: The excimer laser is a viable treatment for vitiligo and may yield results more expeditiously than other commonly utilized therapies. The rapid response may be correlated with skin type, but a more extensive study needs to be undertaken to further evaluate this correlation.