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Background: Stable non-segmental vitiligo is often resistant to conventional therapies., Objectives: The purpose of this study was to investigate the effect of three types of fractional lasers in the treatment of stable non-segmental vitiligo., Materials & Methods: Twenty patients were enrolled in the study. The vitiligo lesions of each patient were divided into four treatment parts, and all parts were treated with narrowband ultraviolet-B (NB-UVB). Three of the four parts were respectively treated with three types of fractional lasers (two ablative 10,600-nm CO 2 lasers and one non-ablative 1,565-nm laser), followed by topical betamethasone solution application. The treatment period lasted six months. Efficacy and satisfaction were respectively assessed by dermatologists and patients., Results: The ablative CO 2 lasers, in combination with topical betamethasone solution and NB-UVB, achieved marked to excellent improvement on white patches assessed by dermatologists. Patients showed high satisfaction scores for the treatments. The non-ablative 1,565-nm fractional laser did not provide any further benefit in the treatment of vitiligo. No severe adverse events developed for any of the treatments., Conclusion: The treatment protocol with ablative CO 2 lasers, in combination with topical betamethasone solution and NB-UVB, was suitable for stable non-segmental vitiligo. For vitiligo, the ablative fractional CO 2 laser is more effective than the non-ablative fractional laser.

Background: Photodynamic therapy (PDT) has been used for acne, however, the efficacy and safety need to be determined., Objective: To assess the effects and safety of PDT for acne using an evidence-based approach., Methods: Randomized controlled trials (RCTs) on the treatment of acne with PDT were identified by searching PubMed, CNKI and the Cochrane Library., Results: A total of 14 RCTs involving 492 patients were included. Photosensitizers included aminolevulinic acid (ALA), methylaminolevulinate (MAL), and indole-3-acetic acid (IAA). Light sources included red light, pulsed dye laser (PDL), intense pulsed light (IPL), long-pulsed dye laser (LPDL) and green light. The PDT protocols, including ALA + red light, ALA + PDL, ALA + IPL, MAL + red light, and MAL + LPDL, all showed great efficacy on inflammatory lesions. ALA + red light also had effects on non-inflammatory lesions and sebum secretion. ALA + IPL and IAA + green light significantly decreased sebum secretion. Triple treatment protocols showed great improvement on inflammatory and non-inflammatory lesions. Increasing ALA concentration, ALA incubation time, PDT sessions, dose of light source or using occlusion for photosensitizers, or a combination of other treatments with PDT may achieve greater efficacy. The common side effects of PDT were tolerable and transient., Conclusion: Limited evidence indicates that PDT shows good efficacy in the treatment of acne with acceptable side effects. ALA + red light was shown to be the optimal choice. However, more RCTs are needed to determine the types and concentrations of photosensitizers and light sources, and the duration of light activation and incubation.

Bullous pemphigoid (BP) has been reported to be associated with significant morbidities and a considerable mortality rate. We retrospectively studied 94 patients with BP in a Chinese tertiary medical center between 2005 and 2010 to evaluate the treatment of BP and prognostic factors for the mortality of BP. Cerebrovascular diseases (42.55%) and hypertension (39.36%) were the most common pre-existing conditions. Cardiopathy, diabetes and psoriasis pre-existed in 24.47%, 22.34% and 5.32%, respectively. Eighty of all 94 patients were treated by systemic corticosteroid at prednisone 0.3 mg/kg to 1.5 mg/kg daily. Patients were followed up for a minimum of 1 year or until the time of death. The mean duration of follow-up was 32 months. Kaplan-Meier analysis showed a 1-year survival probability of 76.6% (standard error 4.4%), with a 95% confidence interval (68.04%, 85.16%). Multivariate analysis revealed that increased age, bedridden condition, presence of cerebrovascular diseases at diagnosis, pre-existing cardiopathy and low serum albumin level were associated with the elevated 1-year mortality rate of BP.

Objective: To systematically review the efficacy and safety of interleukin-12/23 monoclonal antibody (IL-12/23 mAb) on psoriasis., Methods: Relevant randomized controlled trials (RCTs) were identified by systematic literature searches in MEDLINE, OVID, EMBASE, Cochrane Library, and the metaRegister of Controlled Trials. The efficacy outcomes and adverse effects of included RCTs were critically assessed., Results: A total of 3365 participants in 5 multicenter RCTs were included. The RRs of most efficacy outcomes showed significant differences between i) IL-12/23 mAb and placebo at week 12/16; ii) IL-12/23 mAb and etanercept at week 12; iii) IL-12/23 mAb in high dose and IL-12/23 mAb in low dose at week 24/28. Increasing treatment times did not obviously provide additional benefit to efficacy improvement. The adverse events of IL-12/23 mAb were similar to those of controls. Antibodies to IL-12/23 mAb were mostly undetected or shown at low titer. Treatment with IL-12/23 mAb did not influence related biochemical markers., Conclusions: IL-12/23 mAb was effective in the treatment of psoriasis on skin lesions, health-related quality of life and psoriatic arthritis in the short-term. The increase in treatment time points was not associated with additional efficacy and dose-dependence was observed with the ongoing treatment up to week 24/28. The adverse effects were minimal and tolerable.

Palmoplantar pustulosis (PPP) is a chronic recurring and refractory pustular dermatosis. To investigate the efficacy and safety of arotinoid ethylester in patients with PPP, sixteen adult subjects with PPP, who had taken no systemic medications for three months, were enrolled. All the subjects received 0.03 mg of arotinoid ethylester once daily as initial dosage. The number of pustules and lesion area index (LAI) were measured pre- and post-treatment. Repeated measures of one factor ANOVA was used to statistically analyze the data. After 3 months of treatment, pustules disappeared completely in all patients (F = 15.04; p < .0001); LAI decreased significantly (F = 24.54; p < .0001). Complete clearance (100% reduction of LAI and complete disappear of pustules) and near complete clearance (75%-99%) occurred in 6 and 8 patients, respectively; the other two patients exhibited partial clearance (50%-74%). Side effects were observed in 10 patients, but were mild to moderate and well tolerated. Our study suggested that arotinoid ethylester is an effective therapy for PPP with minimal side effects.

Recently there have been some reports concerned the treatment of early stage mycosis fungoides (MF) with narrow-band ultraviolet B (NB-UVB) phototherapy. In most of the previous reports, NB-UVB phototherapy was given three times a week on non-consecutive days. Our aim was to evaluate the effect of a twice weekly regimen of NB-UVB phototherapy in the treatment of early-stage MF. Eight patients with early stage MF received NB-UVB phototherapy twice weekly. Six patients (75%) had a complete response in a mean of 23.4 treatments, two (25%) had a partial response. Upon discontinuation of treatment, four patients with complete response relapsed in a mean time to relapse of 5 months. The twice weekly regimen of NB-UVB phototherapy is effective and well-tolerated in the treatment of early stage MF.