الفهرس | Only 14 pages are availabe for public view |
Abstract The 308-nm monochromatic Excimer light (MEL) may present some advantages as compared to Narrow Band Ultraviolet B (NB UVB) for the treatment of vitiligo. To the best of our knowledge, no studies compared the histopathological changes of vitiligo lesions before and after treatment by MEL and NB UVB. To compare the early effects of NB UVB phototherapy and 308-nm MEL in vitiligo patients clinically, histopathologically and immunohistochemically. Thirty patients with non-segmental vitiligo were enrolled in this study. Vitiligo lesions were treated twice weekly for 6 weeks with 308-nm MEL, while NB-UVB phototherapy was used to treat lesions contra laterally. Skin biopsies were taken from lesional areas before and after 6 weeks of phototherapy by either modality for histopathological study with Haematoxylin & Eosin (H&E) or immunohistochemically using Human Melanoma Black-45 (HMB-45) stain. Repigmentation showed a superior statistical significance towards MEL in comparison to NB UVB (p<0.001).Twenty one lesions (70%) were improved by MEL while only four lesions (13.3%) improved by NBUVB. The cumulative dose for MEL was 12.7±2.5 j/cm2 while that for NB UVB was 15.5±4.2 j/cm2 making it significantly lower than NBUVB in only 12 sessions. mmunohistochemistry findings: All lesions before treatment had labeling index for HMB-45 stain (number of pigmented cells / nonpigmented cells) of 0.0 (0%). After treatment the LI for MEL was 4.2±2.6 while for NB UVB LI was 0.3±0.7. H&E findings: MEL showed higher statistical significance regarding increase of basal pigmented cells, and a significant decrease in vacuolated keratinocytes than NB UVB. Although NB UVB is a standard treatment option for vitiligo, MEL is recognized as an effective vitiligo treatment that induces more repigmentation than NB-UVB, and more rapidly on both clinical and histopathological levels, as this was confirmed by our study. |