{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:31:23Z","timestamp":1792855883370,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>Conventional treatment of vitiligo on hands and feet often produces an unsatisfactory result. Various ablative treatment methods were tried with favorable results in facial, neck, and truncal areas. The aim of this study is to evaluate the efficacy and safety of combined fractional CO<jats:sub>2<\/jats:sub> laser, narrowband UVB (NB\u2010UVB) phototherapy, and topical clobetasol propionate in managing stable vitiligo in difficult\u2010to\u2010treat areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A prospective randomized\u2010intraindividual study was conducted on 27 patients with 27 pair\u2010lesions of non\u2010segmental vitiligo on both hands. The lesions were randomized to receive treatment with fractional CO<jats:sub>2<\/jats:sub> laser, NB\u2010UVB phototherapy, and 0.05% clobetasol propionate cream (Group A) or NB\u2010UVB phototherapy and 0.05% clobetasol propionate cream (Group B). Fractional CO<jats:sub>2<\/jats:sub> laser was performed at 1\u2010week interval for 10 sessions. NB\u2010UVB phototherapy was administered twice weekly for 20 sessions. Patients were evaluated 12 weeks after the last treatment. Outcome was evaluated objectively based on standard digital photographs, patient satisfaction, and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six patients completed the study. Six vitiligious lesions (23.1%) in group A achieved good to excellent repigmentation compared with one lesion (3.9%) in group B (<jats:italic>P<\/jats:italic>\u2009=\u20090.065). The overall mean improvement score was 1.35 (\u00b11.38) in group A and 0.50 (\u00b10.95) in group B (<jats:italic>P<\/jats:italic>\u2009=\u20090.0004). Patients' satisfaction score was significantly higher for the lesions in group A than group B. Lesions on the dorsum of the hand showed a higher response rate than those on the fingers. No serious side\u2010effects were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates that adding fractional CO<jats:sub>2<\/jats:sub> laser treatment to NB\u2010UVB phototherapy and topical steroids improves the repigmentation rate of vitiliginous lesions on hands in some patients. This technique may be offered to vitiligo patients who are unresponsive to other treatments. Lasers Surg. Med. 48:197\u2013202, 2016. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.22389","type":"journal-article","created":{"date-parts":[[2015,7,15]],"date-time":"2015-07-15T00:28:24Z","timestamp":1436920104000},"page":"197-202","source":"Crossref","is-referenced-by-count":65,"title":["Effects of a preceding fractional carbon dioxide laser on the outcome of combined local narrowband ultraviolet B and topical steroids in patients with vitiligo in difficult\u2010to\u2010treat areas"],"prefix":"10.1002","volume":"48","author":[{"given":"Vasanop","family":"Vachiramon","sequence":"first","affiliation":[{"name":"Division of Dermatology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayada","family":"Chaiyabutr","sequence":"additional","affiliation":[{"name":"Division of Dermatology Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok 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