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Combination Therapy with 308-nm Excimer Laser, Compound Glycyrrhizin, and Tacrolimus for Pediatric Facial and
Yingying Qian1, Yafen Wu1, Wei Li1
1Department of Dermatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Insights
Combination therapy including 308-nm excimer laser, glycyrrhizin, and tacrolimus is a safe and effective treatment for pediatric vitiligo. This approach offers faster repigmentation and higher efficacy compared to medication alone.
Area of Science:
- Dermatology
- Pediatric Dermatology
- Phototherapy
Background:
- Vitiligo is a common depigmenting disorder in children, causing significant cosmetic and psychosocial distress, especially with facial and cervical involvement.
- Urgent need exists for safe and effective treatments to manage disease progression and promote repigmentation in pediatric patients.
Purpose of the Study:
- To evaluate the efficacy, safety, and repigmentation patterns of 308-nm excimer laser combined with oral compound glycyrrhizin and topical 0.03% tacrolimus in children with facial and cervical vitiligo.
Main Methods:
- A randomized study involving 112 pediatric patients with facial and cervical vitiligo.
- Treatment group received 308-nm excimer laser, oral compound glycyrrhizin, and topical 0.03% tacrolimus twice weekly for 16 weeks.
- Control group received oral compound glycyrrhizin and topical 0.03% tacrolimus only.
Main Results:
- The combination therapy group showed significantly higher overall efficacy (89.53%) compared to the control group (70.51%).
- Initial repigmentation occurred significantly faster in the treatment group (face: 3.12 weeks, neck: 3.74 weeks) versus controls (face: 4.08 weeks, neck: 4.54 weeks).
- Adverse events were rare and self-limited; repigmentation patterns differed, with mixed patterns predominating in the treatment group.
Conclusions:
- Combination therapy with 308-nm excimer laser, compound glycyrrhizin, and 0.03% tacrolimus is a safe and effective treatment for pediatric facial and cervical vitiligo.
- This combined approach leads to faster repigmentation, higher efficacy rates, and distinct repigmentation patterns compared to medical therapy alone.
Background:
Vitiligo is a common acquired depigmenting disorder in pediatric dermatology. Facial and cervical involvement is particularly distressing due to cosmetic disfigurement, leading to psychosocial impairment in children and significant psychological burden for parents. Safe and effective treatment strategies to halt disease progression and promote repigmentation are urgently needed.
Objective:
To evaluate the clinical efficacy, onset of repigmentation, safety, and repigmentation patterns of 308-nm excimer laser combined with oral compound glycyrrhizin and topical 0.03% tacrolimus in children with facial and cervical vitiligo.
Methods:
A total of 112 pediatric patients were randomized into two groups: treatment group (n=56, 86 lesions) received oral compound glycyrrhizin, topical 0.03% tacrolimus, plus 308-nm excimer laser twice weekly for 16 weeks; control group (n=56, 78 lesions) received compound glycyrrhizin and tacrolimus only. Clinical efficacy, time to initial repigmentation, adverse events, and repigmentation patterns (marginal, follicular, mixed) were assessed.
Results:
The overall efficacy rate was significantly higher in the treatment group (89.53%) than in controls (70.51%) (p<0.05). Initial repigmentation occurred earlier in the treatment group (face: 3.12±0.45 weeks; neck: 3.74±0.44 weeks) compared with controls (face: 4.08±0.50 weeks; neck: 4.54±0.51 weeks, both p<0.05). Adverse events were rare (3.57%) and self-limited. Repigmentation patterns differed: treatment lesions showed predominantly mixed repigmentation (65.12%), whereas controls were mainly follicular (57.69%).
Conclusion:
Combination therapy with 308-nm excimer laser, compound glycyrrhizin, and 0.03% tacrolimus is safe and effective for pediatric facial and cervical vitiligo, providing faster repigmentation, higher efficacy, and distinct repigmentation patterns compared with medical therapy alone.
