***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVES We introduce and clinical ly examine a new concept of skin treatment called fractional photothermolysis ( FP ) , achieved by applying an array of microscopic treatment zones ( MTZ ) of thermal injury to the skin . STUDY DESIGN / MATERIAL S AND METHODS Two prototype devices emitting at 1.5 microm wavelength provided a pattern of micro-exposures with variable MTZ density . Effects of different MTZ densities were tested on the forearms of 15 subjects .  Clinical effects and histology were assessed up to 3 months after exposure . Treatment of photoaged skin on the periorbital area in an additional 30 subjects receiving four treatments over a period of 2 - 3 weeks was also tested . Tissue shrinkage and clinical effects were assessed up to 3 months after treatment . RESULTS Pattern densities with spacing of 250 microm or more were well tolerated . Typical MTZ had a diameter of 100 microm and penetrated 300 microm into the skin . Reepithelialization was complete within 1 day . Clinical effects were assessed over a 3-month period . Histology at 3 months revealed enhanced undulating rete ridges and increased mucin deposition within the superficial dermis . Periorbital treatments were well tolerated with minimal erythema and edema . Linear shrinkage of 2.1 % was measured 3 months after the last treatment . The wrinkle score improved 18 % ( P < 0.001 ) 3 months after the last treatment . CONCLUSIONS FP is a new concept for skin restoration treatment . Safety and efficacy were demonstrated with a prototype device . Further clinical studies are necessary to refine the optimum parameters and to explore further dermatological applications Facial vitiligo is associated with considerable psychological impact . The management is challenging and requires multidisciplinary treatment . Adding fractional carbon dioxide ( CO2 ) to the conventional treatment has been reported as an effective modality . This study aim ed to evaluate the efficacy of combined fractional CO2 laser , targeted ultraviolet B ( UVB ) phototherapy , and topical steroid on facial vitiligo . A prospect i ve , r and omized , split face study was conducted on 14 patients with symmetrical non-segmental facial vitiligo . Ten sessions of fractional CO2 laser was performed on the lesions on one side of face with 2-week interval . Immediately after laser , the lesions on both side of face were treated with 10 sessions of 2-week interval targeted UVB phototherapy and twice daily application of topical 0.05 % clobetasol propionate cream . The patients were followed up for 12 weeks after the last treatment . Clinical improvement was grade d by blinded dermatologists and patients using a quartile grading scale . Twelve out of 14 patients completed the study . The degree of improvement was not different between both sides in nine patients . One patient showed more improvement on the combined laser side , and two patients showed inferior results on the combined laser side . Two patients with lesser improvement on the laser-treated side had positive Koebner phenomenon on the non-facial area . The combined treatment with laser , targeted UVB , and topical steroids are not superior to targeted UVB and topical steroids in facial vitiligo . Furthermore , laser may retard the response to the st and ard treatment in patients with Koebner phenomenon on non-treated areas BACKGROUND Fractional CO2 laser and autologous hair transplantation are independently effective in the treatment of refractory and stable vitiligo . OBJECTIVE The authors ' purpose was to evaluate the therapeutic efficacy of fractional CO2 laser pretreatment compared with autologous hair transplantation and phototherapy alone for refractory and stable vitiligo . METHODS A total of 20 patients with refractory and stable vitiligo were enrolled from our clinic . Resistant lesions r and omly divided into 2 regions as follows : ( 1 ) Part A : fractional CO2 laser pretreatment followed by autologous transplantation and phototherapy , and ( 2 ) Part B : autologous transplantation and phototherapy alone . Five days after fractional CO2 laser application to Part A , both treatment regions received a transplant of scalp grafts . On Day 11 , the entire lesion was exposed to narrow-b and UVB phototherapy , twice a week for 12 weeks . The diameter of perifollicular repigmentation was measured monthly with a caliper . RESULTS Perifollicular repigmentation was detectable surrounding 74 % of grafted hair follicles by Month 3 . Furthermore , Part A demonstrated a significantly greater diameter of repigmentation with 6.6 ± 5.8 mm in Part A compared with 4.3 ± 1.8 mm in Part B ( p = < .001 ) . CONCLUSION In this study , our results demonstrate improved efficacy of autologous hair transplantation and narrow-b and UVB with fractional CO2 laser pretreatment in refractory and stable vitiligo BACKGROUND AND OBJECTIVE Conventional treatment of vitiligo on h and s and feet often produces an unsatisfactory result . Various ablative treatment methods were tried with favorable results in facial , neck , and truncal areas . The aim of this study is to evaluate the efficacy and safety of combined fractional CO2 laser , narrowb and UVB ( NB-UVB ) phototherapy , and topical clobetasol propionate in managing stable vitiligo in difficult-to-treat areas . STUDY DESIGN A prospect i ve r and omized-intraindividual study was conducted on 27 patients with 27 pair-lesions of non-segmental vitiligo on both h and s. The lesions were r and omized to receive treatment with fractional CO2 laser , NB-UVB phototherapy , and 0.05 % clobetasol propionate cream ( Group A ) or NB-UVB phototherapy and 0.05 % clobetasol propionate cream ( Group B ) . Fractional CO2 laser was performed at 1-week interval for 10 sessions . NB-UVB phototherapy was administered twice weekly for 20 sessions . Patients were evaluated 12 weeks after the last treatment . Outcome was evaluated objective ly based on st and ard digital photographs , patient satisfaction , and adverse events . RESULTS Twenty-six patients completed the study . Six vitiligious lesions ( 23.1 % ) in group A achieved good to excellent repigmentation compared with one lesion ( 3.9 % ) in group B ( P = 0.065 ) . The overall mean improvement score was 1.35 ( ± 1.38 ) in group A and 0.50 ( ± 0.95 ) in group B ( P = 0.0004 ) . Patients ' satisfaction score was significantly higher for the lesions in group A than group B. Lesions on the dorsum of the h and showed a higher response rate than those on the fingers . No serious side-effects were noted . CONCLUSION This study demonstrates that adding fractional CO2 laser treatment to NB-UVB phototherapy and topical steroids improves the repigmentation rate of vitiliginous lesions on h and s in some patients . This technique may be offered to vitiligo patients who are unresponsive to other treatments The aim of this study is to evaluate the use of fractional carbon dioxide laser ( CO2 ) with betamethasone and salicylic acid solution in the treatment of patients with refractory vitiligo in h and s. Each h and of the patient was r and omly assigned to one of two groups : lesion treated with fractional carbon dioxide laser associated with betamethasone and salicylic acid solution administration or lesion treated only with betamethasone and salicylic acid solution . We conclude that combined treatment with fractional carbon dioxide laser and betamethasone associated with salicylic acid solution could effectively and safely be used in the treatment of refractory vitiligo Background : Recently , narrow-b and ultraviolet B ( NB-UVB ) and topical immunomodulators have been successfully used in the treatment of vitiligo . Objective : To determine whether the combination of pimecrolimus with NB-UVB accelerates the response time and /or improves the degree of response in patients with vitiligo . Methods : Sixty-eight patients with vitiligo enrolled in this r and omized , double-blind , placebo-controlled study . The patients were r and omized into two groups and treated with NB-UVB plus either pimecrolimus or placebo for 3 months . Tri-weekly radiation was started at 280 mj/cm2 , with 15 % increments for each subsequent treatment until erythema was reported or a maximum of 800 mj/cm was achieved . At baseline and 6 and 12 weeks after commencement of therapy , vitiliginous patches were measured . Results : Fifty patients completed the 3-month study . No significant side effects except self-limited erythema and pruritus were observed . After 12 weeks of treatment , repigmentation of the facial lesions was higher in patients treated with combined pimecrolimus and NB-UVB compared with the placebo plus NB-UVB group ( 64.3 vs 25.1 % ) ( p < 0.05 % ) . There was no statistically significant difference in the repigmentation rate between the two groups on other body areas . Conclusion : On the face , NB-UVB works better if combined with pimecrolimus 1 % cream rather than used alone Background Stable non-segmental vitiligo is often resistant to conventional therapies . Objectives The purpose of this study was to investigate the effect of three types of fractional lasers in the treatment of stable nonsegmental vitiligo . Material s & methods Twenty patients were enrolled in the study . The vitiligo lesions of each patient were divided into four treatment parts , and all parts were treated with narrowb and ultraviolet-B ( NB-UVB ) . Three of the four parts were respectively treated with three types of fractional lasers ( two ablative 10,600-nm CO2 lasers and one non-ablative 1,565-nm laser ) , followed by topical betamethasone solution application . The treatment period lasted six months . Efficacy and satisfaction were respectively assessed by dermatologists and patients . Results The ablative CO2 lasers , in combination with topical betamethasone solution and NB-UVB , achieved marked to excellent improvement on white patches assessed by dermatologists . Patients showed high satisfaction scores for the treatments . The non-ablative 1,565-nm fractional laser did not provide any further benefit in the treatment of vitiligo . No severe adverse events developed for any of the treatments . Conclusion The treatment protocol with ablative CO2 lasers , in combination with topical betamethasone solution and NB-UVB , was suitable for stable non-segmental vitiligo . For vitiligo , the ablative fractional CO2 laser is more effective than the non-ablative fractional laser Objective : The purpose of this study is to compare the efficacy of three therapies in the treatment of non-segmental vitiligo : a combination of topical calcipotriol , narrowb and -ultraviolet B ( NB-UVB ) , and betamethasone therapies ; a combination of NB-UVB and topical calcipotriol ; and NB-UVB alone . Material and methods : Forty-five patients with non-segmental vitiligo presenting to our Dermatology clinic were recruited to participate in the study . Patients were r and omly divided into three groups . For each patient the size of the depigmented areas was assessed according to the rule of nines . The first group was treated with a combination of topical calcipotriol , NB-UVB , and betamethasone therapies . The second group was treated with a combination of NB-UVB and topical calcipotriol and third group was treated with NB-UVB alone . Since the patients ' vitiligo lesions had similar phototypes , all patients were started with 0.1 j/cm2 , regardless of their skin phototype . The dose of NB-UVB was increased 10 % in each session and no further increment was done after reaching 2.5 j/cm2 . Treatment effectiveness was evaluated according to the percentage improvement in repigmentation . The quality of life of the patients was measured by the Dermatology Life Quality Index ( DLQI ) . Results : The patients were aged from 13 to 55 years ( mean : 25.29 ) . The duration of disease ranged from 3 months to 20 years . Family history was positive for vitiligo in 10 patients ( 22.2 % ) . The percentage of recovery after treatment was 63.33 % ± 7.55 in group 1 , 60.67 % ± 5.75 in group 2 , and 46.67 % ± 7.98 in group 3 . There was no statistically significant difference between groups 1 and 2 , and groups 2 and 3 , but there was a statistically significant difference between groups 1 and 3 ( p = 0.0048 ) . Conclusions : In conclusion , NB-UVB-alone therapy and the combined therapies are effective treatment options in the treatment of vitiligo . Future studies with larger groups are warranted to confirm our results 
    Output:
    
These results provide evidence supporting that fractional CO2 laser is a valuable treatment modality for patients with vitiligo , especially for those with refractory vitiligo