Silverberg reports being an advisor, consultant, investigator or speaker for Incyte, Novan, Novartis, Pfizer, Regeneron/Sanofi Aventis, Verrica and Vyne. Sethi reports no relevant financial disclosures.
Therapy using a 308 nm laser was effective in inducing long-term repigmentation of the face in pediatric vitiligo, particularly in facial lesions, according to researchers.
“The long-term outcome of therapeutics used to treat pediatric vitiligo has been poorly documented in the literature,” Sumit Sethi, MBBS, MD, DNB, of the department of dermatology at Venkateswar Hospital in New Delhi, and Nanette B. Silverberg, MD, of the departments of dermatology and pediatrics at Icahn School of Medicine at Mount Sinai in New York City, wrote.
This is one reason that clinicians can find it difficult to set expectations for long-term results of therapy, according to the researchers.
In the institutional review board-exempt chart review, Sethi and Silverberg evaluated outcomes for pediatric patients with vitiligo treated with a 308 nm laser. Eligible participants had undergone this procedure through the first 6 months of 2016. Ultimately, 15 patients were included.
The researchers recorded information ranging from patient demographics and location of disease to therapeutic parameters of the laser.
Outcomes were assessed at long-term follow-up visits in 2021, with an average follow-up duration of 3.38 years. Specifically, the researchers reviewed pigmentation at later office visits.
Results showed that 86.7% of patients experienced initial repigmentation of the face, while 80% reported initial repigmentation of the body and 61.7% in the extremities.
Over the long-term follow-up period, 80% of facial repigmentation was retained, according to the findings. In addition, 40% of body repigmentation and 20% of extremity repigmentation were retained.
An 18-site scoring method to assess the extent of vitiligo may have some utility in determining who is likely to respond to intervention with a 308 nm laser. However, this method requires broader evaluation, according to the authors.
It was acknowledged that 308 nm laser therapy may be cost-prohibitive and time-consuming for many patients. In addition, children with more than five vitiligo lesions were less likely to respond to the intervention, as were those with rapidly worsening disease.
However, the findings also showed that the lasers were more effective when combined with topical therapies such as calcineurin inhibitors.
All of this information may aid clinicians in more accurately describing expected outcomes for their patients.
“Pediatric vitiligo responds well to the 308 nm laser, with the best retention of repigmentation for facial lesions,” the researchers concluded. “Patients and parents should be counseled on the likelihood of long-term retention of repigmentation and regarding the need for the ongoing management of vitiligo even after repigmentation is initially achieved after 308 nm laser therapy.”