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308 nm Excimer Laser is Effective for Vitiligo and Scleroderma

05/08/2019

1.Introduction of 308 nm excimer laser machine

The mechanism of ultraviolet light in the treatment of vitiligo may be related to the apoptosis of T cells. Immunohistochemistry showed that the 308-nm ultraviolet light could clear the infiltrating T lymphocytes in the skin lesions.It was found that ultraviolet light at 308 nm could promote the apoptosis of activated T cells in vitiligo lesions.After irradiation, T cells can undergo apoptosis, so that the skin lesions not only completely disappear at the naked eye level, but also return to normal tissue structure at the microscopic level.Vitiligo is characterized by selective melanocyte destruction and may be associated with an autoimmune response.Ultraviolet light with a wavelength of 308nm in narrow-spectrum uvb may play an immunomodulatory role in cell and humoral immunity, which can stabilize the process of depigmentation.Recent studies have shown that various cytokines and inflammatory mediators increase after exposure to UVB, suggesting that this is a mechanism by which UVB induces pigment recovery.Ultraviolet light at 365 nm 6nm has the function of enhancing cellular immunity, which can simulate the premature apoptosis of cells caused by ultraviolet B segment, improve the regeneration of metabolic epithelium and kill bacteria, mainly targeting at skin lesions.

2.Main application of 308 nm excimer laser machine

Due to the discovery of the therapeutic effect of 308nm excimer laser on skin diseases, the us FDA began to use it in the treatment of skin diseases in 2000. In 2005, it was certified by the state food and drug administration (CFDA) and entered China.The 308nm excimer laser therapeutic instrument is a device for clinical medicine to generate excimer laser.308nm excimer laser is mainly used in clinical treatment of vitiligo, psoriasis, dermatitis and chronic eczema.

The skin treatment effect of 308nm excimer laser is as follows:

1) stimulate melanocyte proliferation and promote melanocyte production.

2) inducing T cell death.

3) promote the production of vitamin D3.

4) activation of pseudocatalase.

 

3.Features of 308 nm excimer laser machine

1) research results of wuhan institute of physics and mathematics, Chinese academy of sciences.

2) the world’s only semiconductor crystal (solid) laser anti-vitiligo equipment.

3) the enemy of vitiligo, psoriasis.

4) the world’s first UVB+UVA1 combined therapy platform.

 

4.Principle of 308 nm excimer laser machine

The etiology and pathogenesis of vitiligo are still unclear, and there are many hypotheses to explain various clinical manifestations.The mechanism of 308 nm excimer laser in the treatment of vitiligo may be related to the apoptosis of T cells.Bianchi et al. showed that 308 nm excimer laser can remove infiltrated T lymphocytes in the skin lesions by immunohistochemical method.Novak et al. found that 308 nm excimer laser can promote apoptosis of activated T cells in vitiligo lesions.Its effect is more obvious than the ability of narrow wave ultraviolet ray to induce apoptosis.After irradiation, T cells can undergo apoptosis, so that the skin lesions not only completely disappear at the naked eye level, but also return to normal tissue structure at the microscopic level.Vitiligo is characterized by selective melanocyte destruction and may be associated with an autoimmune response.Narrow-spectrum uvb (NB2UVB) may play an immunomodulatory role in cell and humoral immunity, which can stabilize the process of depigmentation.In addition, narrow-spectrum uvb is also widely recognized to have similar efficacy to PUVA (psoralen photochemotherapy) in stimulating residual melanocytes to accumulate in the outer root sheath of the peripheral hair follicle.Melanocyte mitosis, melanogenesis and its migration are often induced by a variety of cytokines and inflammatory mediators, including interleukin 1, TNF, and leucone-c4.Recent studies have shown that various cytokines and inflammatory mediators increase after exposure to UVB, suggesting that this is a mechanism by which UVB induces pigment recovery.

 

5.Advantages of 308 nm excimer laser machine

1) green safety: non-toxic side effects, no drug dependence, has been approved by China CFDA certification, patients can rest assured to choose.

2) safe without damage: for the cause, direct to the lesion, without any damage to healthy skin.

3) stable band, rapid effect, short treatment time: it is a pulsed light wave treatment technology, through a single band of 308nm excimer laser, the energy is effectively focused on the lesion, targeted treatment, effective rapid treatment time than traditional instruments shortened 3-5 times.

4) high cure rate: the cure rate of 308nm excimer laser skin treatment system is over 90%.

5) no special site restrictions: applicable to all types of white spots, various parts of the body, head and face, mucosa, genital can be treated.And can choose the spot of different area to have treatment according to different treatment area, avoid to hurt normal skin effectively.

6) preferred treatment for vitiligo in pregnant women and children: suitable for all groups, all ages, is not suitable for long-term medication, not suitable for melanin cultivation, for pregnant women, infants, weak constitution, xenon 308 chloride laser technology is the preferred treatment for vitiligo.

7) the early treatment effect is obvious, effectively prevent recurrence: 308 laser technology special light waves, on the one hand can rapidly induce T cell apoptosis, on the other hand can make the melanin fully activated, severely, fundamentally thoroughly solve the problem of melanin cells are destroyed, effectively prevent recurrence, has an obvious effect of early treatment of vitiligo.

8) follow treatment at any time without delaying study and work: receiving 308 laser treatment without preparation before irradiation, the formal irradiation time is short, follow treatment at any time without affecting the work and study of patients.

 

6.Treatment differences of 308 nm excimer laser machine

There are individual differences of excimer laser in the treatment of vitiligo.It is related to the following factors: skin color (skin type), skin lesion time (generally short onset time and rapid recovery), skin lesion site (the best treatment effect of head and facial trunk, followed by limbs, poor treatment of palm and plantar on the dorsum of fingers and more times than that of head and facial).

Excimer laser in the treatment of psoriasis, individual differences are not significant, but there are also small differences in skin lesions (head and face trunk than limbs).

What are the reasons for the difference in therapeutic effect between different body parts?

The direct reasons for the formation of unusual type of vitiligo is white spot melanocyte because of T lymphocyte immune killing due to death of T lymphocytes in immune damage when need to identify the safety of the target of “identity”, which means the vitiligo t-cell specificity recognition and destruction of melanocyte, the human hair follicle melanocyte exist in a state of nature in they do not express the characteristics of melanocyte tags, so generally can escape the killer T cells, the recovery of vitiligo need excimer laser stimulation of these remaining in the original state of melanocyte growth as a function of mature melanocyte and bringing back vitiligo skin,This is the reason why when vitiligo is recovered, the pigment islets often appear around the sweat pores first, and then the islets expand and finally recover. The difference in the response of different parts of the body to treatment is related to the distribution density of hair follicles in different parts of the body, the type of hair follicles, and the blood supply to the skin.There is no follicular structure in the palm and plantar so treatment is most difficult.

 

7.Security of 308 nm excimer laser machine

1) is the excimer laser treatment system safe and can it damage the skin?

Excimer laser treatment of skin diseases is very safe, it has been approved by China’s CFDA, and there has been no adverse reactions reported, not to mention the risk of cancer.Its square spot can avoid laser irradiation of normal tissue, minimizing damage to normal skin.

2) is there any possibility of adverse reactions?

During treatment, there is only a slight burning sensation at the irradiated site, and some patients may feel a slight pain (similar to mild sunburn) at the site several hours after treatment.For patients with psoriasis may appear some erythema, or a short period of postoperative pigmentation (recoverable).In patients with vitiligo, there is almost no side effect, occasionally resulting in slight blisters due to increased energy.

3) can excimer laser cause skin cancer?

Traditional phototherapy, especially UVA (PUVA) or UVB, has been reported to cause skin cancer.The 308 excimer laser from the study has not been reported to induce skin cancer.

4) in addition to vitiligo and psoriasis, molecular laser treatment system can also treat those diseases?

Excimer laser is licensed for the treatment of vitiligo and psoriasis.More and more extensive applications have been verified by the clinical practice of domestic and foreign doctors, including various diseases of pigment loss, such as atrophic scar, stretch marks, palmoplantar impetigo, alopecia areata, infant eczema, neurodermatitis and other refractory skin diseases.

5) can it be used for babies?

Excimer lasers can be used safely in people of all ages, from infants to the elderly.

6) what is the difference between the 308 excimer laser and the excimer laser used to treat myopia?

There are many kinds of excimer laser, such as ArF(193nm), KrCl(233nm), KrF(248nm), XeCl(308nm), XeF(353nm), etc. Ophthalmology generally USES ArF at 193nm and KrF at 248nm. Different excimer laser selection is selected by laser characteristics and therapeutic purposes.

 

8.Intended population of 308 nm excimer laser machine

The effect of laser therapy varies with location and age of onset.The best suitable population for 308nm therapeutic instrument:

1) better curative effect on face, neck and trunk and limbs;

2) patients with vitiligo who are less than 18 years old and have a weak constitution have better efficacy;

3) the light beam has no harm to pregnant women, so it is suitable for pregnant women;

4) Xtrac excimer laser treatment system is effective for advanced vitiligo.

Applicable patients:

1) patients with initial vitiligo

2) patients with vitiligo acromelitigo, segmentary type, normal type, hair follicle type, and localized type

3) patients with persistent vitiligo

4) patients with recurrent relapse after treatment of vitiligo

5) children with vitiligo, etc

 

9.Contraindication of 308 nm excimer laser machine

If the patient has the following symptoms, it is forbidden to use the excimer laser treatment system:

1) patients with photoallergy

2) patients with keloid or a history of keloid formation

3) patients with birthmark tumor or a history of the formation of the tumor

4) patients with diffuse squamous cell carcinoma.

 

10.Advances in laser therapy of 308 nm excimer laser machine

Vitiligo is a common skin disease, and the current treatment methods are various, including systemic and local hormone therapy, immunomodulator therapy, surgical treatment and traditional Chinese medicine treatment, among which light therapy is one of the most effective treatment methods.In 1975, PUVA(psoralen photochemotherapy) was used to treat skin diseases such as psoriasis and vitiligo.In 1981, Parrish and Jaenicke experiment found that UVB(medium-wave ultraviolet) with a wavelength between 300 and 313 nm was the most effective in the treatment of psoriasis. Based on this theory, narrow spectrum UVB(NB2UVB, 311 nm) therapy for psoriasis obtained more superior efficacy than traditional therapy.In 2001, zhengzhou huaxia hospital of vitiligo and many other scientific research institutions applied 308 nm excimer laser to the clinical treatment of a 24-year-old female patient with vitiligo. The results showed that the treatment effect of 308 nm excimer laser was more accurate.

Vitiligo experts clearly pointed out that: the 308-nm excimer laser is highly effective, safe and can selectively act on lesions and lesions, making it the best choice for vitiligo phototherapy.

 

11.Summarize of 308 nm excimer laser machine

The high energy, high density, targeting, accuracy and compliance of our 308nm treatment instrument can significantly improve the treatment effect of vitiligo and scleroderma.

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