308nm excimer lamp VS 308nm excimer laser for treating vitiligo
What is excimer 308-nm light treatment?
Excimer 308-nm light is a form of targeted phototherapy that delivers a specific wavelength (308 nm) of ultraviolet B (UVB) radiation using an excimer laser or an excimer lamp. Both have shown similar results regarding efficacy, but have technical differences.
Excimer light treatment is a development of whole body narrowband UVB. Narrowband UVB delivers energy at a wavelength between 311–312 nm for the treatment of localised psoriasis and vitiligo. The disadvantages of narrowband UVB include irradiation of the whole body and the need for a high number of treatments (usually between 15 and 40 sessions).
Compared with narrowband UVB, its advantages are:
Healthy skin surrounding the affected areas is not exposed to radiation
Different templates are used according to the area to be treated
A higher dose of radiation can be delivered, with a reduced cumulative dose of irradiation
In some cases, a shorter course of treatment is effective
It can be used in areas difficult to reach with conventional phototherapy
It can be used in children, as it is a relatively friendly–looking piece of equipment.
The 308-nm excimer laser and 308-nm excimer lamp have both been shown to be effective in treating vitiligo but a direct comparison has never been performed.
F. Le Duff, E. Fontas,* D. Giacchero, L. Sillard, J.-P. Lacour, J.-P. Ortonne and T. Passeron do a research about 308-nm excimer laser and 308-nm excimer lamp
Objectives :To test the equivalence of these two devices for treating nonsegmental vitiligo.
Patients and methods A randomized monocentric study was undertaken. One lesion was treated with the 308-nm excimer laser and its counterpart with the 308-nm excimer lamp. Lesions were treated twice weekly with the same dose on both sides for a total of 24 sessions. The evaluation was done by two independent physicians blinded to the treatment on direct light and ultraviolet light photos.
Results: Twenty patients were included: 17 completed the study and 104 lesions were treated. The two treatments showed similar results in terms of efficacy for a repigmentation of at least 50% . The lamp induced more erythema than the laser.
Conclusions: The 308-nm excimer lamp and laser showed a similar efficacy in treat-ing vitiligo. For the same fluence, the lamp induced more erythema suggesting photobiological differences between the two devices.
(a) Laser side before treatment; (b) lamp side before treatment; (c) laser side 1 month after the end of the treatment; (d) lamp side 1 month after the end of the treatment.
In conclusion, the 308-nm excimer laser and the 308-nm excimer lamp are equivalent for inducing repigmentation of vitiligo. While both devices deliver roughly the same wave-length, they are not totally comparable. Indeed, the laser and lamp are different in terms of physical properties and cost. The 308-nm excimer lamp induces more erythema than the 308-nm excimer laser suggesting different photobiological effects that require further investigation. Although the 308-nm excimer laser allows quicker treatments, it remains expensive and its use is restricted to rare specialized centres. The 308-nm excimer lamp is smaller and less expensive and could allow 308-nm excimer targeted phototherapy to become more accessible.
308_Eximer_System_vs_Laser_Vitiligo_Ortonne_EN.pdf