FlexSys UVB 308 nm

Vitiligo

Vitiligo is a relatively common acquired disorder, characterized by progressive loss of melanocytes from the epidermis and the epidermal appendages.⁽¹⁾

However, treating vitiligo that spreads on less than 10% of the total body surface by NB-UVB unnecessarily exposes healthy areas to radiation. Targeted UVB therapy with 308 nm allows a selective treatment of the lesions.⁽²⁾

Treatment Protocol

Pre-Treatment Procedure

  • Remove any cosmetics.
  • Wear appropriate eye protection.
  • MED Test:
    • MED test is not necessary as the affected area will not respond as normal tissue does.

Treatment Procedure

  • Start treatment at 100 mJ/cm² (150 mJ/cm² on darker skin) at first session.
  • Increase in steps of 100 mJ/cm² per session as long as tolerable for the patient.
  • No blister formation should occur.
  • If crusting or blistering occurs, decrease energy by 100 mJ/cm² and stay at this “max” fluence for the next two sessions.
  • Start increasing afterwards by 50 mJ/cm² every second session.

Post-Treatment Procedure

  • The use of moisturizer is recommended.

Treatment Cycle

  • One to two treatments per week (on non-consecutive days) to obtain a ”trigger healing” effect.
  • When reasonable result is seen, two treatments per week.
  • When a good result is seen, one treatment per two weeks.

Total Number of Treatments (estimated)

  • 15 – 30 treatment sessions required depending on response.

Pictures

Before and after four treatments

Contraindications

(excerpt only, all contraindications and side effects are listed in the user manual)

  • Dermatosis with Koebner phenomenon
  • Auto-immune light-sensitive dermatoses: Lupus, Dermatomyositis
  • Elevated photo-sensitivity
  • Photo-sensitizing medication
  • Photogen dermatosis, photodermatosis
  • Personal or family anamnesis of melanoma
  • Pregnancy (no study available)
  • Cutaneous infection in the treatment area

References

  1. ^ “Effectiveness of a 308-nm excimer laser in treatment of vitiligo: a review”. Published in “Lasers in Medical Science”, Issue 3/2013 by Alauldin Khalef Alhowaish, Nathalie Dietrich, Meltem Onder, Klaus Fritz. Retrieved 03 February 2023.
  2.  ^ “Treatment of Vitiligo by 308-nm Excimer Laser: An Evaluation of Variables Affecting Treatment Response”. Published in “Lasers in Surgery and Medicine 35:152–156 (2004)” by Ostovari, T. Passeron, W. Zakaria, E. Fontas, J.C. Larouy, J.F. Blot, J.Ph. Lacour, and J.P. Ortonne. Retrieved 03 February 2023.

Short Protocol

↑= Increase, # = Treatment
Parameter:Fluence:
Start with 100 mJ/cm²
↑ in steps of 100 mJ/cm² per #
Clinical endpoint:Endpoint is slight erythema
No crusting
Treatment cycle:1 – 2 # per week
Minimum 48 hour interval
Estimated total number of treatments:15 – 30 #
Expected results:Repigmentation of lesions

Annotations

  • Apply dose to affected skin only.
  • Minimum 48 hour interval between consecutive treatments
  • Efficiency depends on localization (“>” = “better than”):
    face > neck > trunk > bony prominences > extremities