Efficacy and Safety of Combined Platelet-Rich Plasma With Fractional Laser for Adult Patients With Vitiligo: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

IF 2.3 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology Pub Date : 2025-05-19 DOI:10.1111/jocd.70245

Xiaowei Feng, Shali Jiang, Xingwei Zou, Yongqiong Deng, Jinwei Xie

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引用次数: 0

Abstract

Objective

Platelet-rich plasma (PRP) is a novel treatment option for vitiligo. It has been reported to be effective in combination with other methods, such as fractional laser. However, there is no consensus on the specific combined use of PRP with fractional laser. Therefore, this meta-analysis assessed the efficacy and safety of this combination regimen compared to control groups for vitiligo.

Methods

A comprehensive literature search was conducted for relevant randomized controlled trials comparing PRP plus fractional laser with other routine treatments published from inception to January 2025. Data regarding the mean grade of repigmentation, patient's satisfaction score, rate of satisfactory repigmentation or no response, and incidence of side effects were extracted and meta-analyzed using a fixed or randomized model.

Results

Seven studies involving 366 patients were reviewed. The combination of PRP and fractional laser therapy significantly improved the mean grade of repigmentation (mean difference [MD] = 1.58; 95% confidence interval [CI] = 1.08–2.07; p < 0.01) and patients' satisfaction score (MD = 1.87; 95% CI = 0.90–2.83; p = 0.0001), while also reducing the no response rate (risk ratio [RR] = 0.54; 95% CI = 0.32–0.92; p = 0.02), compared with control groups, including monotherapy, topical drug or sun exposure only, and fractional lasers plus narrowband ultraviolet B. Additionally, the incidence of adverse events for combination therapy was comparable to that of control groups (RR = 0.86; 95% CI = 0.69–1.07; p = 0.17).

Conclusions

This meta-analysis provides evidence supporting the combined use of PRP and fractional laser therapy as a valuable and safe treatment modality for patients with vitiligo, based on its superiority to control groups and comparable rates of side effects. However, more well-designed and large-scale studies are required to confirm it.

查看原文本刊更多论文

富血小板血浆联合激光治疗成人白癜风的疗效和安全性：随机对照试验的系统评价和荟萃分析

目的富血小板血浆（PRP）治疗白癜风是一种新的治疗方案。据报道，它与其他方法如分数激光联合使用是有效的。然而，关于PRP与分数激光的具体联合使用尚无共识。因此，本荟萃分析评估了该联合方案与对照组相比治疗白癜风的有效性和安全性。方法全面检索自成立以来至2025年1月发表的PRP +分数激光与其他常规治疗的相关随机对照试验。提取有关色素沉着的平均等级、患者满意度评分、色素沉着满意率或无反应率以及副作用发生率的数据，并使用固定或随机模型进行meta分析。结果回顾了7项研究，涉及366例患者。PRP联合分步激光治疗可显著改善色素沉着的平均分级(平均差值[MD] = 1.58；95%置信区间[CI] = 1.08-2.07；p < 0.01)和患者满意度评分(MD = 1.87；95% ci = 0.90-2.83；p = 0.0001)，同时也降低无反应率(风险比[RR] = 0.54；95% ci = 0.32-0.92；p = 0.02)，与对照组相比，包括单药治疗，局部药物或阳光照射，分数激光加窄带紫外线b。此外，联合治疗的不良事件发生率与对照组相当(RR = 0.86；95% ci = 0.69-1.07；p = 0.17)。结论：本荟萃分析提供证据支持PRP联合局部激光治疗作为白癜风患者的一种有价值且安全的治疗方式，基于其优于对照组和相当的副作用率。然而，需要更多精心设计的大规模研究来证实这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cosmetic Dermatology DERMATOLOGY-

CiteScore

4.30

自引率

13.00%

发文量

818

审稿时长

>12 weeks

期刊介绍： The Journal of Cosmetic Dermatology publishes high quality, peer-reviewed articles on all aspects of cosmetic dermatology with the aim to foster the highest standards of patient care in cosmetic dermatology. Published quarterly, the Journal of Cosmetic Dermatology facilitates continuing professional development and provides a forum for the exchange of scientific research and innovative techniques. The scope of coverage includes, but will not be limited to: healthy skin; skin maintenance; ageing skin; photodamage and photoprotection; rejuvenation; biochemistry, endocrinology and neuroimmunology of healthy skin; imaging; skin measurement; quality of life; skin types; sensitive skin; rosacea and acne; sebum; sweat; fat; phlebology; hair conservation, restoration and removal; nails and nail surgery; pigment; psychological and medicolegal issues; retinoids; cosmetic chemistry; dermopharmacy; cosmeceuticals; toiletries; striae; cellulite; cosmetic dermatological surgery; blepharoplasty; liposuction; surgical complications; botulinum; fillers, peels and dermabrasion; local and tumescent anaesthesia; electrosurgery; lasers, including laser physics, laser research and safety, vascular lasers, pigment lasers, hair removal lasers, tattoo removal lasers, resurfacing lasers, dermal remodelling lasers and laser complications.