Consensus on the safety and risks of laser and intense pulse light (IPL) treatments in vitiligo patients, an e-Delphi study - supplementary files
Description
Background: Laser and IPL treatments carry the risk of inducing new vitiligo lesions (Koebner phenomenon). This combined with the absence of guidelines leads to reluctance to administer these treatments in vitiligo patients. Objective: The aim of this study was to achieve consensus on the safety, strategies to minimize risks, and treatment recommendations of laser and IPL treatments in vitiligo patients. Methods: An e-Delphi study, with 51 items, was performed. Consensus was achieved when ≥70% of the participants agreed with the item. Results: Thirty-two items reached consensus (62.8%). We agreed that every laser/IPL treatment, even in ideal circumstances, poses a risk of inducing vitiligo in predisposed patients. Pinpoint-like lesions, the Koebner phenomenon, and hypochromic borders enhance the risk, whereas test-spots are recommended to minimize the risk. Unless there is stability >1 year and absence of activity signs, we advise not to treat. We recommend treating laser/IPL-induced vitiligo like normal vitiligo, and to start early treatment when epidermal damage occurs after a laser/IPL treatment. Limitations: This is an expert opinion-based consensus study, with little evidence available in current literature. Conclusion: Consensus was achieved on the safety, strategies to minimize risks, and treatment recommendations for laser and IPL treatments in vitiligo patients.