A comparative study for the short-term effects of targeted high-intensity UVB and narrow-band UVB in the treatment of vitiligo

Design and Implementation of a Heating Treatment System for Vitiligo Skin Disease Based on Medical Ultrasound

Vitiligo is relatively common clinically. It is an acquired and persistent skin and mucosal pigment depigmentation disease. As a noninvasive and nonradioactive treatment, high-energy ultrasound has been applied to skin diseases of vitiligo. Treatment achieved good clinical results. This article analyzes the structure of the original medical ultrasound system for vitiligo and finds the deficiencies and missing components of the system. On the basis of the original design scheme, a new structural scheme was designed, which solved the shortcomings of the original system and added missing parts. Subsequently, according to actual application requirements and specific component performance, the schematic design, including audio and video input, output and storage, DDR3, Ethernet, and the design of key circuits, such as power supply modules, are specifically introduced. Later, in the PCB design, the contents including stacking, layout, routing, and simulation of key signals were introduced in detail. The design includes a probe excitation signal generation module, excitation signal parameter control module, high voltage and temperature monitoring module, and corresponding power conversion module. This paper is mainly to develop a vitiligo skin disease heating treatment array system based on the principle of both cost and performance. This paper is based on the nonrigid registration algorithm of the FFD model and HPV interpolation and the nonrigid registration algorithm combining shape information and SIFT method. In the focused ultrasound treatment system, the image-guided positioning and monitoring functions are realized. Studies have shown that when the peak voltage of the transmitter circuit is 55 V, the sound power is 0.28 W. It can be seen that the transmitting circuit system designed in this article is a relatively stable and reliable system, which is suitable for the ultrasound treatment of vitiligo skin diseases.

The efficacy of fractional carbon dioxide laser combined with narrow-band ultraviolet B phototherapy for non-segmental vitiligo: a systematic review and meta-analysis

Fractional carbon dioxide (CO₂) laser has been used with conventional treatments for vitiligo, demonstrating more effectiveness compared with conventional treatments alone. Especially, fractional CO₂ 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 CO₂ 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 CO₂ 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 CO₂ 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 CO₂ 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 CO₂ laser combined with NB-UVB might be more effective for treating non-segmental vitiligo than NB-UVB monotherapy.

Evaluation of using fractional CO2 laser plus NB-UVB versus NB-UVB alone in inducing marginal repigmentation of vitiligo lesions

Background: Vitiligo is a common depigmenting skin disorder, characterized by patchy loss of skin color and finding effective treatment has remained a challenging issue. Methods: A paired (half-body) randomized clinical trial study was done to compare the efficacy and the safety of narrowband ultraviolet B (NB-UVB) plus fractional CO₂ versus NB-UVB alone in stimulation of marginal repigmentation of vitiliginous patches. One side of the body was randomly treated with a fractional CO₂ laser and NB-UVB twice weekly, while the other side was exposed only to NB-UVB with the same manner. Results: Thirty patients with the nonsegmental stable vitiligo and mean age of 43 ± 15 years completed a 16-week treatment period with NB-UVB on one side of the body and fractional CO₂ laser therapy with NB-UBV on the other side. In addition to the higher rate of response in the combination side compared to the monotherapy side of the body (p < .001), repigmentation was greater in the combination side rather than the NB-UVB monotherapy side (p = .002). In the combination treated side, marginal repigmentation pattern was more frequently seen than perifollicular pattern (p < .001) and more frequently than monotherapy side (p < .001). Conclusion: The fractional CO₂ laser combined with NB-UVB seems to be a more effective therapeutic option for treatment than NB-UVB alone for inducing marginal repigmentation.