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Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study

Nanja van Geel (UGent) , Lien Depaepe (UGent) and Reinhart Speeckaert (UGent)
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Abstract
Background: Depigmentation therapy can be an option in adults with extensive and refractory vitiligo. Remaining pigmented patches can be removed using depigmentation creams (monobenzyl ether of hydroquinone 20%), laser therapy or cryotherapy. In contrast to cream treatment, laser therapy and cryotherapy are fast and targeted methods, capable of destroying melanocytes selectively on one specific area. Up till now, controlled trials comparing laser and cryotherapy as depigmenting treatment in vitiligo are lacking. Material and methods: We performed a retrospective comparative study in 22 generalized vitiligo patients. Thirty-one pigmented test regions were exposed to cryotherapy and 20 to 755nm laser therapy. The mean surface area per test region was 3.55cm(2) and number of treatments per test region was limited to one single session in 84.3% and varied up to four sessions (2.0%). Results: Overall no significant difference in the capacity to induce depigmentations was observed between cryotherapy (46.7%) and laser therapy (42.9%) after one treatment. The percentage of induced depigmentation was significantly different according to the body location (P=0.005) with best results on the trunk, followed by the arms, face, neck and less on the hands. Variables that positively influenced depigmentation results were a younger age of vitiligo onset (P=0.012), skin type V (P<0.001) and clinical presence of Koebner's phenomenon (P=0.039). Despite initial failure after one treatment, repetitive treatment sessions on eight test areas resulted in successful depigmentation. Side-effects were restricted to cryotherapy and concerned mainly hyperpigmentation in the face. Conclusion: To our knowledge, this is the first study comparing head-to-head depigmentation strategies intra- and inter-individually. We could demonstrate that in general laser and cryotherapy are equally effective in inducing depigmentations in generalized vitiligo patients. Retreatment of the same area may be required in case of initial failure.
Keywords
SWITCHED RUBY-LASER, Cryotherapy, SKIN, REPIGMENTATION, MELANOCYTES, UNIVERSALIS, MANAGEMENT, THERAPY, CELLS, Vitiligo, Laser

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Chicago
van Geel, Nanja, Lien Depaepe, and Reinhart Speeckaert. 2015. “Laser (755 Nm) and Cryotherapy as Depigmentation Treatments for Vitiligo: a Comparative Study.” Journal of the European Academy of Dermatology and Venereology 29 (6): 1121–1127.
APA
van Geel, N., Depaepe, L., & Speeckaert, R. (2015). Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study. JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 29(6), 1121–1127.
Vancouver
1.
van Geel N, Depaepe L, Speeckaert R. Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study. JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY. 2015;29(6):1121–7.
MLA
van Geel, Nanja, Lien Depaepe, and Reinhart Speeckaert. “Laser (755 Nm) and Cryotherapy as Depigmentation Treatments for Vitiligo: a Comparative Study.” JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY 29.6 (2015): 1121–1127. Print.
@article{5975909,
  abstract     = {Background: Depigmentation therapy can be an option in adults with extensive and refractory vitiligo. Remaining pigmented patches can be removed using depigmentation creams (monobenzyl ether of hydroquinone 20\%), laser therapy or cryotherapy. In contrast to cream treatment, laser therapy and cryotherapy are fast and targeted methods, capable of destroying melanocytes selectively on one specific area. Up till now, controlled trials comparing laser and cryotherapy as depigmenting treatment in vitiligo are lacking. 
Material and methods: We performed a retrospective comparative study in 22 generalized vitiligo patients. Thirty-one pigmented test regions were exposed to cryotherapy and 20 to 755nm laser therapy. The mean surface area per test region was 3.55cm(2) and number of treatments per test region was limited to one single session in 84.3\% and varied up to four sessions (2.0\%). 
Results: Overall no significant difference in the capacity to induce depigmentations was observed between cryotherapy (46.7\%) and laser therapy (42.9\%) after one treatment. The percentage of induced depigmentation was significantly different according to the body location (P=0.005) with best results on the trunk, followed by the arms, face, neck and less on the hands. Variables that positively influenced depigmentation results were a younger age of vitiligo onset (P=0.012), skin type V (P{\textlangle}0.001) and clinical presence of Koebner's phenomenon (P=0.039). Despite initial failure after one treatment, repetitive treatment sessions on eight test areas resulted in successful depigmentation. Side-effects were restricted to cryotherapy and concerned mainly hyperpigmentation in the face. 
Conclusion: To our knowledge, this is the first study comparing head-to-head depigmentation strategies intra- and inter-individually. We could demonstrate that in general laser and cryotherapy are equally effective in inducing depigmentations in generalized vitiligo patients. Retreatment of the same area may be required in case of initial failure.},
  author       = {van Geel, Nanja and Depaepe, Lien and Speeckaert, Reinhart},
  issn         = {0926-9959},
  journal      = {JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY},
  keyword      = {SWITCHED RUBY-LASER,Cryotherapy,SKIN,REPIGMENTATION,MELANOCYTES,UNIVERSALIS,MANAGEMENT,THERAPY,CELLS,Vitiligo,Laser},
  language     = {eng},
  number       = {6},
  pages        = {1121--1127},
  title        = {Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study},
  url          = {http://dx.doi.org/10.1111/jdv.12762},
  volume       = {29},
  year         = {2015},
}

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