The efficacy of fractional carbon dioxide laser combined with narrow-band ultraviolet B phototherapy for non-segmental vitiligo: a systematic review and meta-analysis
- Authors
- Kim, Woo Il; Kim, Sooyoung; Lee, Sang Hoon; Cho, Moon Kyun
- Issue Date
- Feb-2021
- Publisher
- Springer Verlag
- Keywords
- Vitiligo; Fractional carbon dioxide laser; NB-UVB; Meta-analysis
- Citation
- Lasers in Medical Science, v.36, no.1, pp 165 - 173
- Pages
- 9
- Journal Title
- Lasers in Medical Science
- Volume
- 36
- Number
- 1
- Start Page
- 165
- End Page
- 173
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/2076
- DOI
- 10.1007/s10103-020-03069-0
- ISSN
- 0268-8921
1435-604X
- Abstract
- Fractional carbon dioxide (CO2) laser has been used with conventional treatments for vitiligo, demonstrating more effectiveness compared with conventional treatments alone. Especially, fractional CO(2)laser combined with narrow-band ultraviolet B (NB-UVB) was shown to induce more improvement compared with NB-UVB monotherapy for treating stable non-segmental vitiligo. However, the effectiveness of fractional CO(2)laser plus NB-UVB for the treatment of non-segmental vitiligo remains controversial. Therefore, this study aimed to confirm the safety and efficacy of fractional CO(2)laser combined with NB-UVB compared with NB-UVB monotherapy in stable non-segmental vitiligo. We searched the data from different databases, including Cochrane, Embase, and PubMed up to January 2020. Four randomized controlled trials (RCTs) for comparison between fractional CO(2)laser plus NB-UVB and NB-UVB monotherapy in patients with stable non-segmental vitiligo were included. We performed meta-analyses for repigmentation improvement and patient satisfaction as well as subgroup analyses based on acral or non-acral vitiligo, according to the PRISMA guidelines. The combination treatment showed more superior results than NB-UVB monotherapy (>= 75% repigmentation, RR 4.60, 95% CI 1.19-17.74; >= 50% repigmentation, RR 2.24, 95% CI 0.45-11.17; < 25% repigmentation, RR 0.81, 95% CI 0.60-1.08). Also, fractional CO(2)laser plus NB-UVB significantly improved acral and non-acral vitiligo compared with NB-UVB monotherapy (standard mean difference (SMD) 1.24, 95% CI 0.66-1.82; SMD 1.14, 95% CI 0.67-1.60, respectively), while it increased markedly patient satisfaction compared with NB-UVB monotherapy (SMD 1.12, 95% CI 0.66-1.58). Collectively, this meta-analysis suggested that fractional CO(2)laser combined with NB-UVB might be more effective for treating non-segmental vitiligo than NB-UVB monotherapy.
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Collections - College of Medicine > Department of Dermatology > 1. Journal Articles
- College of Medicine > Department of Dermatology > 1. Journal Articles
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