Psoralen plus UV-A photochemotherapy (PUVA) is one of the most effective therapies available for vitiligo; however, a significant number of treated patients respond poorly or not at all.1 We treated vitiligo lesions with the ultrapulse carbon dioxide laser and concomitant PUVA treatments in 2 patients who did not respond to PUVA therapy alone in the hope that growth factors created by superficial epidermal destruction would potentiate the effect of PUVA locally. We compared these results with those seen in 4 other patients who also received ultrapulse carbon dioxide laser treatment of vitiligo macules who were not receiving PUVA therapy. Only laser-treated lesions in patients receiving PUVA, who did not respond previously to PUVA therapy alone, showed re-pigmentation.
Report of Cases. Six patients (average age, 39 years) with diffuse vitiligo (average duration, 18 years) were divided into 2 groups: those who were receiving but had not responded to PUVA therapy
Knoell KA, Schreiber AJ, Milgraum S. Treatment of Vitiligo With the Ultrapulse Carbon Dioxide Laser in Patients Concomitantly Receiving Oral Psoralen Plus UV-A Therapy. Arch Dermatol. 1997;133(12):1605–1606. doi:10.1001/archderm.1997.03890480131026