Impacts of Two Laser-Assisted Epidermal Ablation Techniques on the Efficacy of Autologous Non-Cultured Epidermal Cell Suspension Transplantation Plus Narrowband Ultraviolet B Phototherapy for the Treatment of Stable Vitiligo: A Retrospective Study.

Objectives: Autologous non-cultured epidermal cell suspension (NECS) transplantation is an effective therapeutic approach for managing stable vitiligo, and laser-assisted epidermal ablation is a common recipient area preparation procedure before NECS transplantation. We sought to compare the efficacy and safety of two different lasers used in NECS transplantation combined with narrowband ultraviolet B (NB-UVB) therapy for treatment of stable vitiligo.

Materials and methods: In this retrospective study, 63 white macules in 54 patients with stable vitiligo were assessed for the repigmentation rate and any adverse effects associated with NECS transplantation combined with NB-UVB therapy at 1, 3, and 6 months post-transplantation. The epidermis was ablated using either a Kinglaser CO2 fractional laser used in the fully ablative mode at 100% coverage (KL) or an ultra-pulse CO2 laser (UL).

Results: At the 6-month follow-up, the repigmentation rates in the KL group were graded as excellent in 28.6%, good in 9.5%, fair in 42.9%, and poor in 19.0%, giving an effective rate of 38.1%. In the UL group, the rates were graded as 73.8%, 14.3%, 7.1%, and 4.8%, respectively, giving an effective rate of 88.1% (p < 0.001). The Visual Analog Scale score for pain during the laser-assisted epidermal ablation was higher in the UL group than in the KL group (p < 0.0001). The UL group had a significantly higher incidence of mild to moderate persistent erythema at 1 month post-transplantation than the KL group (p = 0.002).

Conclusions: UL can achieve better repigmentation efficacy than KL when used for epidermal ablation during NECS transplantation plus NB-UVB therapy in patients with stable vitiligo. However, regarding adverse events, the UL procedure is more painful and has a higher incidence of mild to moderate persistent erythema during the early postoperative period. Larger studies are required to assess the impacts of various laser de-epidermalization techniques on the efficacy of NECS transplantation for stable vitiligo.