Effectiveness of 308-nm Excimer Light with Pimecrolimus and Crisaborole in Pediatric Vitiligo: A Retrospective Study.

Purpose: To systematically evaluate the efficacy and safety of 308-nm excimer light therapy combined with topical pimecrolimus cream and crisaborole ointment in children with non-segmental vitiligo, using dermatoscopy, ImageJ software, Wood's lamp examination, and a color difference meter. Patients and Methods: A retrospective study was conducted involving 120 pediatric patients diagnosed with non-segmental vitiligo who attended the Department of Dermatology, The Second Affiliated Hospital of Wenzhou Medical University, between January 2023 and December 2023. Patients were divided into three groups based on treatment regimen. Group 1 received 308-nm excimer light therapy combined with pimecrolimus cream. Group 2 received 308-nm excimer light therapy combined with crisaborole ointment. Control group received 308-nm excimer light therapy. Baseline images of skin lesions were obtained under natural light, Wood's lamp illumination, and dermatoscopic examination. All patients received once-weekly phototherapy sessions for 12 consecutive weeks, with treatment efficacy assessed at 4-week intervals. Treatment response rates, adverse events, and repigmentation patterns were systematically evaluated and compared across treatment groups. Results: The overall treatment efficacy and repigmentation area demonstrated a progressive increase with successive treatment cycles. After 4 weeks of therapy, the response rates for Group 1, Group 2, and the control group were 34.1%, 32.1%, and 23.8%, respectively, with no statistically significant difference observed (P > 0.05). After 8 weeks of treatment, the response rates increased to 63.4%, 60.2%, and 42.8%, respectively, with statistically significant differences among groups (P < 0.05). Following 12 weeks of treatment, the response rates for Group 1, Group 2, and the control group further increased to 76.8%, 71.7%, and 54.8%, respectively (P < 0.05). The combination therapy groups exhibited significantly higher efficacy rates compared with the phototherapy-only group. Clinical efficacy varied significantly across different anatomical sites (P < 0.05), with the highest treatment response observed in the face and neck, followed by the trunk, extremities, and acral regions. Regarding treatment safety, no statistically significant differences in the incidence of adverse reactions were observed between the combination therapy groups and the phototherapy-only group (P > 0.05). Conclusion: With increasing treatment duration, the therapeutic efficacy and repigmentation area of vitiligo lesions show a progressive improvement. The combination of 308-nm excimer light therapy with topical pimecrolimus cream and crisaborole ointment demonstrates favorable efficacy in pediatric vitiligo, with only mild and well-tolerated adverse reactions. The integrated use of dermatoscopy, ImageJ software, Wood's lamp examination, and a color difference meter provides an objective, quantitative, and reproducible approach for digitally documenting changes in lesion color and area before and after vitiligo treatment.