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ROY G. GERONEMUS, MD.
P.C. LEONARD .1. BERNSTEIN. M.D.
ARIELLE N. B. KAUVAR, M.D.
MACRENE ALEXIADES-ARMENAKAS. M.D., Ph.D.
December 5, 2001
Leo Borrell, M.D.
Cosmetic Surgery Affiliates
4150 Westheimer, #103 Houston, Texas 77027
Dear Dr. Borrell:
For several years now I have been trying to find ways to help
my patients with leukoderma. Through a combination of research and
an approved IDE study we noticed that leukoderma appeared to show
moderate to excellent repigmentation through the use of phototherapy,
both UV-A with psoralen and UV-B radiation microtherapy. It was
these findings that led us to try the 308nm excimer laser.
The bright
part of our findings is that our preliminary results suggest that
the 308-nm excimer laser offers a rapid and effective treatment
for stimulating residual melanocytes in patients with resurfacing-induced
leukoderma at a relatively low cumulative UV-B dose. There is no
pain, wounding, or need for postoperative care. The mechanism of
UV-B repigmentation is probably related to the stimulation of melanocyte
migration and proliferation by the release of cytokines and inflammatory
mediators in the skin.
Our initial trial was published in the Archives of Dermatology.
In this study, one patient noted a greater than 75% improvement
in pigmentation after 8 treatment sessions; 4 weeks after the initiation
of treatment. In another patient a 50 to 75% improvement in pigmentation
after 10 treatment sessions was seen' At the 4-week follow-up
there was no loss of the repigmentation. Our center has now treated
over sixty patients with leukoderma. These cases also included patients
with post surgical scars, bums, as well as leukoderma from dermabrasion
and laser resurfacing.
Leukoderma, the late complication of carbon dioxide laser resurfacing
and other injuries, is usually very distressing to patients, and
anything we can do to help relieve this distress is in the patients'
best interest. The 308 nm excimer laser has already received FDA
clearance for psoriasis, vitiligo and just recently eczema. At this
time the 308 nm excimer laser is not cleared for use on Leukoderma,
but based on our promising results you may want to consider using
it for this condition. If you want more information about our study
on Leukoderma you can read about it in The Archives of Dermatolo
gy, June 2001.
I wish you and your patients the best.
Sincerely
Roy G. Geronemus, M.D.
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