![]() Q-Switched laser treatments with the intention to induce depigmentation were excluded. Laser/IPL-induced leukoderma or vitiligo was defined as a progressive depigmentation in a laser/IPL treated area (in patients with or without a history of vitiligo). Dermatologists were asked to report every case of laser-induced leukoderma or vitiligo over the past year and to report how many vitiligo patients they approximately encountered (face to face) over the past year. Questions were divided into 3 sections: the affected patients, the involved laser/IPL treatments and the physicians’ approach ( supplementary file appendix 1). 14 questions were carefully formulated and pretested by dermatologists (AL, AW and MB). We developed an online questionnaire in Google Forms. The aim of this international survey study among vitiligo experts was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced leukoderma or vitiligo. To date, only anecdotal evidence from six case reports is available on laser or IPL induced vitiligo. In the absence of any guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. Furthermore, a systematic review showed evidence for the Koebner phenomenon in relation to active vitiligo. Vitiligo patients with a history of Koebner phenomenon tend to have higher body surface area (BSA) involvement, an earlier age at onset of vitiligo and elevated risk of further depigmentation despite treatment. Various kinds of skin injury may induce the Koebner phenomenon in vitiligo patients, including physical injury, mechanical trauma, chemical burns, thermal burns, allergic reactions, chronic pressure and therapeutic interventions. However, by causing trauma to the skin, there’s a risk of inducing new depigmented patches called the Koebner phenomenon. Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments and other laser or intense pulsed light (IPL) assisted treatments. Vitiligo is a pigmentary disorder characterized by sharply demarcated depigmented macules with a potentially high social and psychological burden. This study showed significant variation in the current recommendations and approach of vitiligo experts regarding laser/IPL-induced leukoderma or vitiligo. Therefore, caution is advised with aggressive settings and test-spots prior to the treatment are recommended. However, a majority had laser/IPL-induced skin damage. Consequently, most cases could not have been prevented by not treating vitiligo patients. Remarkably, a minority had a medical history of vitiligo of which 58% were stable. Laser-induced leukoderma or vitiligo is an uncommon phenomenon. Relevant activity signs are the Koebner phenomenon (57.1%), confetti-like lesions (57.1%) and hypochromic borders (50%). These vitiligo experts based their advice on the risk of the laser treatment on stability of the vitiligo (43%) and activity signs (50%), and 50% discuss the risks before starting a laser treatment. ![]() Side effects like blistering, crusting, and erosions occurred in 56.7% of the cases. Most frequently reported were hair removal procedures and localization of the face and legs. Of these, 12 (40%) patients had a medical history of vitiligo and seven (58%) of these patients had stable (> 12 months) vitiligo before the treatment. In a total of 11,300 vitiligo patients, laser/IPL-induced leukoderma or vitiligo was reported in 30 patients (0.27%). A cross-sectional survey study was performed among 15 vitiligo experts from 11 countries, with 14 questions about affected patients, involved laser/IPL treatments and the physicians’ approach. The aim of this survey study was to provide an estimation of the occurrence and related risk factors of laser/IPL-induced leukoderma or vitiligo. In absence of guidelines on the safe use of laser or IPL in vitiligo patients, dermatologists tend to be reluctant to administer these treatments. ![]() However, there is a risk of inducing new depigmented patches (Koebner phenomenon). ![]() Vitiligo patients may desire laser hair removal, skin rejuvenation, vascular treatments, and other laser or intense pulsed light (IPL) assisted treatments.
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