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Abstract
Background: Treatment of vitiligo represents a major dermatological challenge, therefore many efforts are exerted to introduce new treatment modalities. These modalities may act by changing certain cytokines and metalloproteinases. Aim of work: The aim of this study is to assess the efficacy of TCA chemical peel, dermapen and ablative fractional co2 laser in treatment of stable non- segmental vitiligo and to detect their effects on IL-17 and MMP-9 levels using ELISA. Results: It has been found that the thirty vitiligo patients had low basal tissue MMP-9 levels and high baseline IL-17 tissue levels. As regards the three different used modalities, all of them caused rise in MMP-9 as well as IL-17 levels and almost their levels were much more elevated with repetition of the previously mentioned traumatic procedures. Conclusion: Taking into consideration that elevated IL-17 levels is pathogenic, repeated trauma-based sessions are not preferred and single sessions will probably positively affect MMP-9 levels without marked elevation of IL- 17. TCA 25% peel proved to be the most effective modality both clinically and laboratory. These traumatic lines of treatment could be combined with other conventional therapies that may eliminate and control their possible harmful effect on inflammatory mediators and subsequently on vitiligo.