Clinical efficacy of combined treatment with CO2 dot matrix laser and compound Betamethasone in refractory stable vitiligo
Objective To explore the efficacy and safety of CO2 dot matrix laser combined with compound betamethasone in the treatment of refractory stable vitiligo.Methods A single-center,randomized,self-controlled study was conducted,and a total of 48 patients with vitiligo who had failed to respond to traditional drug therapy and/or phototherapy at the Department of Dermatology,Beijing Chaoyang Hospital,Capital Medical University,between October 2019 and October 2023 were included in the study.Two lesions were selected for each patient,and subsequently,a total of 96 lesions were randomly assigned into two groups using a coin toss.In the control group,48 lesions were treated with 0.1％tacrolimus ointment applied twice daily.In the experimental group,48 lesions were treated with the combined treatment with CO2 dot matrix laser and encapsulation therapy of compound betamethasone injection,followed by the application of 0.1％tacrolimus ointment twice daily.A total of 3 months of treatment was given in both groups.The two groups were compared in terms of lesion area,repigmentation rate,clinical efficacy,patient satisfaction,quality of life,and the incidence of adverse reactions.Results The effectiveness rate in the experimental group(91.67％)was significantly higher than that in the control group(70.83％)(P＜0.05).After treatment,the lesion areas in both groups decreased(P＜0.05),and the lesion area in the experimental group was smaller than that in the control group(P＜0.05).The experimental group achieved a repigmentation rate of 60％(ranging from 48％to 70％),significantly higher than the control group's rate of 18％(ranging from 9％to 24％)(P＜0.05).The patient satisfaction score was also higher in the experimental group compared to the control group(P＜0.05).All patients tolerated the treatment well.In the experimental group,among the 48 lesions,5(10.42％)developed persistent erythema,3(6.25％)had folliculitis,2(4.17％)had telangiectasia,and 6(12.5％)developed hyperpigmentation.No scarring or atrophy was observed.After a 3-month follow-up,erythema and hyperpigmentation had returned to normal,while telangiectasia and folliculitis showed partial recovery.In the control group,among the 48 lesions,2(4.17％)developed folliculitis,with no other adverse reactions reported.After a 3-month follow-up,all adverse effects had resolved.The incidence of adverse reactions was higher in the observation group compared to the control group.Conclusion The combination of CO2 dot matrix laser and encapsulation therapy with compound betamethasone demonstrates efficacy and safety in the treatment of refractory stable vitiligo.
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