INTRODUCTION
Children with lesions on the face and other visible sites are subject to bullying and may have a poor quality of life.1 308-nm laser is used to enhance vitiliginous lesion repigmentation, with limited data in children. Face, neck, and trunk sites respond superiorly.2 It has been demonstrated that repigmentation with a 308-nm laser for vitiligo in children is enhanced with the addition of topical calcineurin inhibitors.3 In larger series addressing outcomes of pediatric vitiligo with traditional therapy, 42.3% achieve a “looking excellent†score, supporting the possibility of good clinical outcomes with traditional interventions for therapy, which includes a 308-nm laser.4 Despite the utility of 308-nm laser as a modality of therapeutic repigmentation, little is known about the retention of pigmentation after treatment.
MATERIALS AND METHODS
An IRB-exempt chart review was conducted in 2016 of children with vitiligo who received a 308-nm laser. Patients were identified through a review of logbooks for individuals actively receiving 308-nm laser from 1/1/2016-6/30/2016. Analysis of available charts was conducted with the extraction of the age of the patient, location and type of lesions, Fitzpatrick skin type, number of sessions and average dosage of 308-nm laser, concomitant therapy, response to the 308-nm laser by the site (face, body, extremities).
All patients received concurrent tacrolimus ointment with the concentration of tacrolimus at 0.1% for 16 years and over, and 0.03% for 2-15 years of age for the duration of laser treatment. Twice-daily application of tacrolimus was requested. For body lesions, mometasone ointment once daily or daily pulsed clobetasol ointment 2 weeks per month (maximum 3 months) were given adjunctively in addition to tacrolimus.
Patients included in the chart review had their chart re-examined in 2021 for the long-term course and retention of pigmentation.
All patients received concurrent tacrolimus ointment with the concentration of tacrolimus at 0.1% for 16 years and over, and 0.03% for 2-15 years of age for the duration of laser treatment. Twice-daily application of tacrolimus was requested. For body lesions, mometasone ointment once daily or daily pulsed clobetasol ointment 2 weeks per month (maximum 3 months) were given adjunctively in addition to tacrolimus.
Patients included in the chart review had their chart re-examined in 2021 for the long-term course and retention of pigmentation.
RESULTS
17 names were identified; however, only 15 charts were available for review at the time of the chart review (Table 1). Patients were on average 10.24 years of age with a mean vitiligo duration of 20.9 months. Seven cases were non-segmental (46.7%), 7 segmental (46.7%) and 1 mixed segmental/ non-segmental (6.6%). All but 1 patient was Fitzpatrick skin types 3-6. The body site most commonly treated was the face 86.7%, followed by legs 33.3%.
Patients with facial disease, whether in isolation or as part of generalized involvement had the best outcomes. Average repigmentation by surface area was 86.7% for the face, 80% for the body, and 61.7% for the extremities.
Patients with facial disease, whether in isolation or as part of generalized involvement had the best outcomes. Average repigmentation by surface area was 86.7% for the face, 80% for the body, and 61.7% for the extremities.