Excimer Laser Plus Minigraft Useful in Vitiligo

LONDON — Excimer laser treatment with minigrafting offers a new approach to repigmentation in vitiligo, according to Dr. Ludmila Nieuweboer-Krobotova of the Netherlands Institute for Pigment Disorders, University of Amsterdam.

The excimer laser has been used alone and in conjunction with topical therapies including tacrolimus and 8-methoxypsoralen. In the first preliminary study using this 308-nm laser with minigrafting in 20 patients with stable vitiligo, nine patients (45%) had 75%–99% repigmentation after 3 months, Dr. Nieuweboer-Krobotova reported in a poster session at the 14th Congress of the European Academy of Dermatology and Venereology.

Minigrafting was performed using 1.5-mm full-thickness punch grafts that were removed from a normally pigmented donor site. Grafted areas then were irradiated with the excimer laser twice weekly for 3 months.

The beginnings of repigmentation were visible after only 2 weeks, which is earlier than when narrowband UVB is used after minigrafting. At 3 months, three patients had 51%–74% repigmentation, four had 25%–50%, and four had 0%–24%.