Efficacy of low-temperature argon plasma in the treatment of non-segmental vitiligo

BACKGROUND: Vitiligo is a chronic depigmenting skin disorder that has a substantial impact on patients’ psychosocial well-being. Currently available treatment options, including long-term use of topical corticosteroids and phototherapy, have several limitations related to adverse effects and depend on skin phototype. This underscores the need for the development and implementation of new, safe, and effective treatment methods for vitiligo. AIM: The study aimed to clinically evaluate the efficacy and safety of low-temperature argon plasma therapy in patients with non-segmental vitiligo. METHODS: This open-label, non-comparative clinical study included patients with a confirmed diagnosis of non-segmental vitiligo (n=20), aged 18–65 years, with a body surface area involvement ranging from 1% to 10%. The participant enrollment and intervention period lasted 8 weeks (20 procedures, 3 times a week), followed by a 1-month follow-up period. Procedures were conducted using the plasma-arc surgical system Plazmoran. The primary efficacy endpoint was the Vitiligo Extent, Stage, and Spreading Index (VETF). Secondary endpoints included the depigmented area (%), the Dermatology Life Quality Index (DLQI; points), and the type and degree of repigmentation. Assessments were performed at baseline, at weeks 4 and 8, and 1 month after treatment. Safety was evaluated based on the number of recorded adverse events. RESULTS: All patients completed the planned treatment course. Complete repigmentation (76–100%) was achieved in 4 patients, marked repigmentation (51–75%) in 7 patients, moderate repigmentation (26–50%) in 6 patients, and minimal repigmentation (1–25%) in 3 patients. A significant reduction in VETF scores was observed, decreasing from 8.4±3.6 at baseline to 6.8±3.2 at week 4, 4.2±2.8 at week 8, and 3.6±2.4 1 month after therapy (p 0.001 for all time points compared with baseline). The depigmented area decreased from 4.6±2.8% to 2.0±1.8% (p 0.001). DLQI scores significantly improved, declining from 18.6±5.4 to 14.2±4.8, 9.8±3.6, and 7.4±2.9, respectively (p 0.001), indicating a marked improvement in quality of life. Comparison of subgroups by disease duration showed that the best outcomes were achieved in patients with a duration of less than 3 years (mean repigmentation 68.5% vs. 32.3% in those with a duration exceeding 7 years). Higher efficacy was observed in lesions located on the face, neck, and trunk compared with acral areas (hands and feet). The predominant repigmentation pattern was follicular (16), followed by peripheral (8) and diffuse (2). Continued repigmentation was noted during the 1-month post-treatment follow-up period. Mild transient adverse events (temporary erythema and sensation of warmth) were reported in 12 patients. CONCLUSION: Therapy using the plasma-arc surgical system Plazmoran demonstrated high clinical efficacy and a favorable safety profile in the treatment of non-segmental vitiligo. The method was not associated with serious adverse events characteristic of conventional therapies (skin atrophy or telangiectasia). These findings support the potential of low-temperature argon plasma as a promising modern therapeutic option for vitiligo in dermatological practice.