关键词: 白癜风, 光疗法, 复色模式, 影响因素, 308 nm准分子激光, 308 nm准分子光

Abstract: 【Abstract】 Objective To analyze factors influencing repigmentation patterns in patients with vitiligo treated with phototherapy. Methods Clinical data were retrospectively collected from patients with vitiligo treated with 308-nm excimer laser or 308-nm excimer lamp at the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2013 to May 2022. The treatment frequency was thrice weekly, and skin lesions were evaluated via photographs once every 5 sessions of phototherapy. Chi-square test or Fisher′s exact test was used to analyze associations between clinical characteristics and vitiligo repigmentation patterns. Results A total of 223 patients with vitiligo were included in this study, including 109 males （48.9%） and 114 females （51.1%）, and their ages （M ［Q1, Q3］） were 20 （10, 28） years. Among the 223 patients, 170 （76.2%） were treated with 308-nm excimer laser, and 53 （23.8%） with 308-nm excimer lamp. The repigmentation patterns included the perifollicular pattern in 63 cases （28.3%）, marginal pattern in 97 （43.5%）, diffuse pattern in 36 （16.1%）, and mixed pattern in 27 （12.1%）. Analysis of the associations between clinical characteristics and vitiligo repigmentation patterns showed no significant differences in the repigmentation patterns among vitiligo patients of different genders or different Fitzpatrick skin types （both P > 0.05）; however, the diffuse repigmentation pattern more frequently occurred in the patients aged ≤ 12 years compared with those aged > 12 years （χ2 = 7.71, P = 0.005）, in the patients with vitiligo in the progressive stage compared with those in the stable stage （χ2 = 4.59, P = 0.030）, and in lesions without white hair compared with those with white hair （χ2 = 6.75, P = 0.009）; the mixed repigmentation pattern more frequently occurred in the patients with segmental vitiligo compared with those with non-segmental vitiligo （χ2 = 11.76, P = 0.001）; the marginal repigmentation pattern more frequently occurred in lesions on the face and neck （χ2 = 15.82, P＜0.001） and extremities （χ2 = 11.85, P = 0.001） compared with lesions on the trunk; the perifollicular repigmentation pattern more frequently occurred in the patients with stable vitiligo compared with those with progressive vitiligo （χ2 = 4.70, P = 0.030）, and in skin lesions on the trunk compared with those on face and neck （χ2 = 13.73, P < 0.001） and extremities （χ2 = 5.49, P = 0.035）; after 308-nm excimer laser treatment, the proportions of patients with the marginal repigmentation pattern （χ2 = 12.30, P < 0.001） and those with the diffuse repigmentation pattern （χ2 = 5.64, P = 0.018） were significantly higher than those after 308-nm excimer lamp treatment, while the proportions of patients with the perifollicular repigmentation pattern （χ2 = 7.87, P = 0.005） and those with the mixed repigmentation pattern （χ2 = 17.13, P < 0.001） were significantly higher after 308-nm excimer lamp treatment than those after 308-nm excimer laser treatment. Conclusion Patients′ age, clinical types and stages of vitiligo, presence or absence of concomitant white hair, skin lesion sites, and phototherapy modalities were factors influencing the repigmentation patterns of vitiligo.

Key words: Vitiligo, Phototherapy, Repigmentation pattern, Influencing factors, 308-nm Excimer laser, 308-nm Excimer lamp