Kaohsiung Journal of Medical Sciences
Volume 24, Issue 4 , Pages 180-189, April 2008

Low-Energy Helium-Neon Laser Therapy Induces Repigmentation and Improves the Abnormalities of Cutaneous Microcirculation in Segmental-Type Vitiligo Lesions

  • Chieh-Shan Wu

      Affiliations

    • Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Stephen Chu-Sung Hu

      Affiliations

    • Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Cheng-Che E. Lan

      Affiliations

    • Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Gwo-Shing Chen

      Affiliations

    • Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Wen-Ho Chuo

      Affiliations

    • Department of Pharmacy, Tajen University, Pingtung, Taiwan
    • ,
  • Hsin-Su Yu

      Affiliations

    • Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Hsin-Su Yu, Department of Dermatology, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan

Received 17 October 2007; accepted 10 December 2007.

Article Outline

Segmental vitiligo (SV) is a special form of vitiligo occurring in a dermatomal distribution, and an abnormality involving the sympathetic nerves supplying the affected dermatome is known to underlie this disorder. Previously, we have shown that SV is associated with an abnormal increase in cutaneous blood flow and adrenoceptor responses in the affected areas. Since SV is resistant to conventional forms of therapy, its management represents a challenge for dermatologists. Low energy helium-neon lasers (He-Ne laser, wavelength 632.8nm) have been employed as a therapeutic instrument in many clinical situations, including vitiligo management and repair of nerve injury. The purpose of this study was to evaluate the effectiveness and safety of He-Ne lasers in treating SV, and determine their effects on the repair of sympathetic nerve dysfunction. Forty patients with stable-stage SV on the head and/or neck were enrolled in this study. He-Ne laser irradiation was administered locally at 3.0J/cm2 with point stimulation once or twice weekly. Cutaneous microcirculatory assessments in six SV patients were performed using a laser Doppler flowmeter. The sympathetic adrenoceptor response of cutaneous microcirculation was determined by measuring cutaneous blood flow before, during and after iontophoresis with sympathomimetic drugs (phenylephrine, clonidine and propranolol). All measurements of microcirculation obtained at SV lesions were simultaneously compared with contralateral normal skin, both before and after He-Ne laser treatment. After an average of 17 treatment sessions, initial repigmentation was noticed in the majority of patients. Marked repigmentation (> 50%) was observed in 60% of patients with successive treatments. Cutaneous blood flow was significantly higher at SV lesions compared with contralateral skin, but this was normalized after He-Ne laser treatment. In addition, the abnormal decrease in cutaneous blood flow in response to clonidine was improved by He-Ne laser therapy. Our study showed that He-Ne laser therapy is an effective treatment for SV by normalizing dysfunctions of cutaneous blood flow and adrenoceptor responses in SV patients. Thus, the beneficial effects of He-Ne laser therapy may be mediated in part by a reparative effect on sympathetic nerve dysfunction.

Key Words:  cutaneous microcirculation , He-Ne laser , segmental-type vitiligo , sympathetic adrenoceptor response

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PII: S1607-551X(08)70115-3

doi:10.1016/S1607-551X(08)70115-3

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 4 , Pages 180-189, April 2008

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