Electrophoto-Biomodulation in Aesthetic Treatment of Postburn Hypopigmentation: Clinical Response in Relation to Histopathological Changes.

BACKGROUND: Hypopigmentation is a troublesome often-permanent sequelae after burn injury, particularly in dark races. A number of methods have been described to treat this phenomenon. In this work, we are going to study the effect of E light (intensive pulsed light+radiofrequency+cooling) in repigmentation of partial thickness and full thickness burn wounds in adult patients and light microscopic changes of biopsy material at various stages of repigmentation.

PATIENTS AND METHODS: In this study, 24 patients with postburn hypopigmentation were selected and E light was used, using different filters, according to the skin color. The intensive pulsed light fluence varied between 38 and 42 J. Radiofrequency fluencies varied between 6 and 10 J, and the spot diameter was 8 × 32 mm. Pulse durations of 2 to 7 milliseconds and pulse delays of 15 to 30 milliseconds were used on all patients.The patients were evaluated by comparing pretreatment and posttreatment photos. Skin biopsies were taken from depigmented area before and after interventions. Melanocytes were immunostained using Hwenty-four homatropine methylbromide 45 and were counted in ×200 magnification fields. Melanin can be demonstrated after staining with hematoxylin and eosin.

RESULTS: Seventeen cases were evaluated as excellent, 4 cases were evaluated as good, and 3 cases were evaluated as fair, but all patients stressed that their wounds have been improved.Light microscopy at 6 weeks posttreatment also confirmed the increased melanocyte number per field in all cases.

CONCLUSIONS: E light induced significant overall clinical improvement in postburn hypopigmentation, particularly when E light was applied early after burn.