Combination Stem Cell Transplantation, Laser Therapy Efficacious in Vitiligo

In a cohort of 56 patients with vitiligo, combining stem cell transplantation with 308 nm excimer laser therapy resulted in clinically significant efficacy. Researchers described the combination of therapies as having a cure rate superior to other widely available and used therapies for vitiligo.

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In a recent study,¹ researchers sought to analyze the clinical use and efficacy of combining stem cell transplanation and laser therapy in vitiligo.

From March 2019 to December 2021, 56 adult patients with stable, non-segmental vitiligo were enrolled as study participants if they had visited the hospital serving as the study center. They were eligible for study participation if they:

• Had not achieved substantial regimentation (“cure”) with other therapies and modalities
• Met diagnostic criteria for vitiligo
• Had no underlying history of photosensitivity or contraindications to ultraviolet radiation
• Did not have dysfunctions of communication or comprehension
• Had not received treatment for vitiligo 1 month prior to stem cell transplantation surgery despite a history of being treated with 308 nm excimer laser for upwards of 6 months, or 20 sessions

Patients who were pregnant, lactating, or presented with vitiligo site infection, malignant skin tumors, and mental system diseases were excluded from participation.

Of the 56 selected study participants, 24 were male and 32 were female, with vitiligo being classified as localized (n=27), generalized (n=19), acrofacial (n=6), or vulgaris (n=4).

All participants underwent excimer laser therapy followed by minimal erythema dose testing. Afterwards, they underwent the stem cell transplantation procedure, which involved being sedated with local anesthesia. During the procedure, researchers extracted outer root sheath containing hair follicle melanocyte stem cells (McSCs). These cells were then cultured in a medium to achieve melanocyte maturation.

All participants were asked to return for post-operative examinations at 1, 3, and 6 months post-procedure.

“In the 56 patients, the treatment was curative in 38 patients (67.85%), markedly effective in 11 (19.64%), effective in 4 (7.14%), and ineffective in 3 (5.35%) within 6 months following one course of treatment. The total treatment response rate was 94.64%,” study authors wrote. “Fifteen patients who completed the second course of treatment were followed up for 1 year. Eleven of them were cured. After two course of treatment a total of 49 (87.5%) patients were cured. The 49 cured patients were treated with 308 nm excimer light for an average of 18.9 times, and the average healing time was 135 days.”

In total, 14 of the 56 participants experienced adverse reactions, which included skin itching and folliculitis.

Through the completion of satisfaction questionnaires, researchers found that 87.5% of participants felt satisfied with the results of the treatment.

“The overall cure rate after 1 year was as high as 87.5% in 56 patients with vitiligo. This cure rate was significantly higher compared with that of various previous therapies, and the effect was more marked,” study authors wrote. “This method is markedly effective for vitiligo on the head, face, trunk, and limbs as well as vitiligo on fingertips, eyelids, alae nasi, lips, vulva, and anal mucosa that had not responded to various therapies.”

Reference

1. Liu J, Chen Q. Clinical effect of stem cell transplantation combined with 308‐nm excimer laser therapy for 56 cases of vitiligo. J Cosmet Dermatol. June 27, 2023. doi:10.1111/jocd.15833