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Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: A Systematic Review with Meta-Analysis.
Am J Clin Dermatol. 2016 Feb; 17(1):23-32.AJ

Abstract

BACKGROUND

Various phototherapy methods are used to treat vitiligo; however, the recent emergence of new devices has heightened debate concerning the best treatment method.

OBJECTIVE

We aimed to systematically review and meta-analyze published data comparing the efficacy and adverse effects of monochromatic excimer lamps versus excimer laser and narrowband ultraviolet B (NB-UVB) in treating vitiligo.

METHODS

A systematic search of PubMed, EMBASE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL), and clinical trials registries identified randomized controlled trials that included vitiligo patients, regardless of age, sex, or study language. We evaluated studies comparing excimer lamps with excimer laser or NB-UVB phototherapy.

RESULTS

The review included six studies (411 patients, 764 lesions). No study found significantly different efficacy between excimer lamps and excimer laser using the outcomes of ≥50% repigmentation [risk ratio (RR) = 0.97, 95% confidence interval (CI) 0.84-1.11] and ≥75% repigmentation (RR = 0.96, 95% CI 0.71-1.30). Likewise, no study found significant differences between excimer lamps and NB-UVB (RR = 1.14, 95% CI 0.88-1.48 for ≥50% repigmentation; RR = 1.81, 95% CI 0.11-29.52 for ≥75% repigmentation). Adverse effects were mild, including pruritus, burning sensation, and dryness, none of which interrupted treatment.

CONCLUSIONS

To our knowledge, this is the first systematic review of the efficacy and safety of excimer lamp treatment for vitiligo. Excimer lamps, excimer laser, and NB-UVB are all safe and effective in repigmentation of vitiligo lesions. Safety, effectiveness, and cost are considerations when choosing treatment.

PROSPERO REGISTRATION NUMBER

CRD42014015237.

Authors+Show Affiliations

Dermatology Department, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.Division of Emergency Medicine and Evidence-Based Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. viticlinsp@yahoo.com.br. Discipline of Rheumatology, Santo Amaro University (UNISA), São Paulo, Brazil. viticlinsp@yahoo.com.br. Disciplina de Medicina Baseada em Evidência, Universidade Federal de São Paulo, Rua Botucatu, 740-3° andar-Vila Clementino, São Paulo, SP, 04023-900, Brazil. viticlinsp@yahoo.com.br.Internal Medicine and Evidence-Based Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. Brazilian Cochrane Center, São Paulo, Brazil.

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

26520641

Citation

Lopes, Celso, et al. "Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: a Systematic Review With Meta-Analysis." American Journal of Clinical Dermatology, vol. 17, no. 1, 2016, pp. 23-32.
Lopes C, Trevisani VF, Melnik T. Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: A Systematic Review with Meta-Analysis. Am J Clin Dermatol. 2016;17(1):23-32.
Lopes, C., Trevisani, V. F., & Melnik, T. (2016). Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: A Systematic Review with Meta-Analysis. American Journal of Clinical Dermatology, 17(1), 23-32. https://doi.org/10.1007/s40257-015-0164-2
Lopes C, Trevisani VF, Melnik T. Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: a Systematic Review With Meta-Analysis. Am J Clin Dermatol. 2016;17(1):23-32. PubMed PMID: 26520641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and Safety of 308-nm Monochromatic Excimer Lamp Versus Other Phototherapy Devices for Vitiligo: A Systematic Review with Meta-Analysis. AU - Lopes,Celso, AU - Trevisani,Virginia Fernandes Moça, AU - Melnik,Tamara, PY - 2015/11/2/entrez PY - 2015/11/2/pubmed PY - 2016/10/13/medline SP - 23 EP - 32 JF - American journal of clinical dermatology JO - Am J Clin Dermatol VL - 17 IS - 1 N2 - BACKGROUND: Various phototherapy methods are used to treat vitiligo; however, the recent emergence of new devices has heightened debate concerning the best treatment method. OBJECTIVE: We aimed to systematically review and meta-analyze published data comparing the efficacy and adverse effects of monochromatic excimer lamps versus excimer laser and narrowband ultraviolet B (NB-UVB) in treating vitiligo. METHODS: A systematic search of PubMed, EMBASE, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL), and clinical trials registries identified randomized controlled trials that included vitiligo patients, regardless of age, sex, or study language. We evaluated studies comparing excimer lamps with excimer laser or NB-UVB phototherapy. RESULTS: The review included six studies (411 patients, 764 lesions). No study found significantly different efficacy between excimer lamps and excimer laser using the outcomes of ≥50% repigmentation [risk ratio (RR) = 0.97, 95% confidence interval (CI) 0.84-1.11] and ≥75% repigmentation (RR = 0.96, 95% CI 0.71-1.30). Likewise, no study found significant differences between excimer lamps and NB-UVB (RR = 1.14, 95% CI 0.88-1.48 for ≥50% repigmentation; RR = 1.81, 95% CI 0.11-29.52 for ≥75% repigmentation). Adverse effects were mild, including pruritus, burning sensation, and dryness, none of which interrupted treatment. CONCLUSIONS: To our knowledge, this is the first systematic review of the efficacy and safety of excimer lamp treatment for vitiligo. Excimer lamps, excimer laser, and NB-UVB are all safe and effective in repigmentation of vitiligo lesions. Safety, effectiveness, and cost are considerations when choosing treatment. PROSPERO REGISTRATION NUMBER: CRD42014015237. SN - 1179-1888 UR - https://www.unboundmedicine.com/medline/citation/26520641/Efficacy_and_Safety_of_308_nm_Monochromatic_Excimer_Lamp_Versus_Other_Phototherapy_Devices_for_Vitiligo:_A_Systematic_Review_with_Meta_Analysis_ L2 - https://dx.doi.org/10.1007/s40257-015-0164-2 DB - PRIME DP - Unbound Medicine ER -