الفهرس 
Effect of topical 5-Fluorouracil alone versus its combination with Er: YAG (2940 nm) laser in treatment of vitiligo
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Abstract
Background: Vitiligo is an acquired disease with a variable course
characterized clinically by well defined depigmented macules or patches
thought to occur secondary to melanocyte dysfunction and loss
Aim of work: To compare the efficacy of topical 5-FU as monotherapy to
combined therapy of topical 5-FU and Er:YAG (2940 nm) laser in the
treatment of non-segmental vitiligo (NSV).
Patients and Methods: This is a prospective randomized comparative
intrapatient study. Thirty patients diagnosed with NSV were recruited from
the dermatology outpatient clinics of the Medical Research Centre of
Excellence, the National Research Centre and the National Institute of
Laser Enhanced Sciences. Our study group was divided into two
subgroups, group 1 was subjected to ablative Er:YAG and 5-FU cream and
group 2 applied topical 5-FU cream. Three treatment sessions were
repeated every 4 to 6 weeks and patients were followed up to 9 months.
Repigmentation was assessed by digital photography and subsequent
computer based image analysis.
Results: Repigmentation of group 1 patients ranged from 0 to 70% (mean
12±7%) whilst in group 2 it ranged from 0 to 5% (mean 1.4±0.8%). Both
groups showed repigmentation in 25/30 (83.3%) on assessment by image
analysis .22/30(73.3%) showed mild to moderate repigmentation and in
3/30 (10%) repigmentation was marked. It started in all patients after
3months and persisted or increased during a period of follow up to 9
months .Groups 1 and 2 were subdivided into A and B, vitiligo involving
non-resistant and resistant areas respectively. group 1A showed more
repigmentation (mean 13.8±8.5%) than group 1B (mean 9.8±4.5%) and
group 2Ashowed more repigmentation (mean 1.5±1%) than group 2B
(mean 1.3±0.5%).
Conclusion: The combination of Er:YAG with 5-FU is safe and effective
in treating and improving the outcome in vitiligo especially of non-resistant
areas. Computer based image analysis is an easy, quick, and reliable
method in assessing post-therapy response