LOW-TEMPERATURE ARGON PLASMA IN COMBINATION THERAPY FOR NON-SEGMENTAL VITILIGO

Background. Narrowband UVB therapy at 311 nm is a first-line treatment for non-segmental vitiligo; however, repigmentation is slow, and some patients demonstrate an insufficient early response. Data on the use of low-temperature argon plasma in combination with phototherapy for non-segmental vitiligo are virtually nonexistent, while the complementary mechanisms of both modalities justify their combination.

Aim of the study. To evaluate the efficacy and safety of the combined use of low-temperature argon plasma and UVB-311 nm compared with UVB-311 nm monotherapy in patients with non-segmental vitiligo, based on changes in the VASI and quality of life (VitiQoL) over 8 weeks and 1 month after completion of treatment.

Methods. Adult patients with non-segmental vitiligo with depigmented lesions assessed by the VASI were included in this prospective, non-randomized, controlled comparative study. Patients with segmental and mixed forms of vitiligo, pregnant women, individuals with photodermatoses, a history of systemic immunosuppressants, and skin cancer were excluded. Patients in the study group received treatment of lesions with the Plasmoran device followed by a UVB-311 nm session, while the comparison group received UVB-311 nm monotherapy. Treatment was administered three times a week for 8 weeks. Assessments were performed at baseline, after 4 , 8 weeks, and 1 month after completion of therapy.

Results. Sixty patients were included; all completed the follow-up. In the main group, the median VASI score decreased from 3.8 to 2.3 points by week 8 (a 39.5% decrease), and in the comparison group, from 4.1 to 3.1 points (24.4%); the difference between groups was 0.5 points [95% CI 0.04–0.96], p = 0.03. After 1 month, the difference remained (2.1 versus 2.9 points, p = 0.04). According to VitiQoL, the median score at week 8 was 30.5 versus 35.0 points (p = 0.04), and after 1 month, 28.0 versus 33.5 points (p = 0.03). The advantage of the combination regimen was significant for non-acral locations and disease durations of less than 5 years. Adverse events were reported in 7 of 28 patients in the study group and 5 of 32 in the comparison group; all were transient and resolved spontaneously.

Conclusion. The combination of low-temperature argon plasma with 311 nm UVB therapy provides a statistically significantly greater reduction in VASI and improvement in quality of life compared to monotherapy. This is a pilot study, conducted in a non-randomized design with a short follow-up, which limits the validity of the conclusions and requires a randomized controlled trial.