Optimal frequency of treatment with the 308-nm excimer laser for vitiligo on the face and neck.

OBJECTIVES: This study was designed to determine the optimal treatment frequency with the 308-nm excimer laser for vitiligo and identify key clinical variable(s) associated with treatment efficacy at the optimal frequency. BACKGROUND DATA: Optimal clinical parameters for excimer laser treatment of vitiligo have not been fully determined. Data about the influence on treatment frequency of different clinical variables of vitiligo are needed to facilitate effective treatment regimens. METHODS: A total of 187 patients were treated with the 308-nm excimer laser for 20 sessions at different frequencies (0.5, 1.0, 2.0, and 3.0 per week). The repigmentation rate was graded on a six-point scale and was blindly evaluated by independent physicians. RESULTS: The final percentage of repigmentation for group 0.5 was statistically lower than those for group 1.0, 2.0, and 3.0, and percentages of final levels of repigmentation among these three groups were not statistically different. The clinical variables showed no statistical differences in the final repigmentation effect. Repigmentation occurred fastest with treatment frequencies of 2.0 and 3.0 and there was no statistically significant difference between them. The onset of repigmentation correlated with the area of vitiliginous patches treated, not with the other clinical variables. CONCLUSIONS: The 308-nm excimer laser is effective for therapy to treat vitiligo on the face and neck. The ultimate laser-induced repigmentation effect does not correlate with treatment frequency and repigmentation occurs faster with treatment frequencies of 2.0 and 3.0 than that of 1.0. It appears that the onset of repigmentation correlates with the total area of vitiliginous patches and the optimal treatment frequency. Monitored studies on a larger population with long-term follow-up would be needed to confirm and extend our findings.

[Reactivity of IgG class of anti-keratin autoantibodies in healthy human sera].

AIM: To analyze the reaction patterns of IgG class of anti-keratin autoantibodies (AK auto Abs) in normal human sera before and after purification, and to explore the effects of serum non-IgG components on the reaction patterns of IgG class of AK auto Abs. METHODS: Titers of IgG AK auto Abs in healthy human sera before and after purification were measured by indirect ELISA, and the reaction patterns of the AK auto Abs to a group of keratins with different relative molecule mass were analysed by Western blot. RESULTS: Titers of purified IgG class of AK auto Abs were higher than those of unpurified sera. Western blot analysis showed purified AK auto Abs recognized more keratins with stronger avidity than unpurified AK auto Abs. The reaction patterns of AK auto Abs from different individuals tended to be homogenous after purification. CONCLUSION: The reaction patterns of serum IgG class of AK auto Abs are influenced by some non-IgG components in sera. The homogeneity of reaction patterns of AK auto Abs from different individuals indicated that B cells producing IgG class of AK auto Abs may be selected by a set of conserved self-antigens, and this process may have no relationship with an individual's exposure to foreign antigens.