Comparison of the Excimer Lamp vs. Narrowband Ultraviolet (Nb-Uvb) Lamp or 308 nm Excimer Laser in Vitiligo Repigmentation: A Systematic Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for your submission on the systematic review comparing the efficacy of the 308 nm excimer lamp/light, the excimer laser, and NB-UVB phototherapy in vitiligo.

Areas for Improvement:

1. Limited Sample Size: Only four randomized controlled trials (RCTs) were included, which raises concerns about the strength of the conclusions. This limitation should be emphasized more clearly in the discussion.

2. Heterogeneity of Protocols: Although you mention the variability in protocols, it would strengthen the paper to include a more detailed exploration or possibly a sensitivity analysis (if feasible) or at least tabulate the variability (e.g., side-by-side comparison table).

3. Critical Appraisal of Evidence: The review largely summarizes findings without critically appraising the implications for clinical practice. For instance, what should clinicians take away, given the mixed bias levels and variability in studies?

4. Figures and Tables: Ensure that figures (like the PRISMA diagram and risk-of-bias graphs) are polished for publication-quality clarity.

5. Conclusion Section: Currently, the conclusion is cautious but very brief. You may expand it with practical recommendations and clear future research directions.

Author Response

Reviewer 1

Thank you for your submission on the systematic review comparing the efficacy of the 308 nm excimer lamp/light, the excimer laser, and NB-UVB phototherapy in vitiligo.

Areas for Improvement:

1. Limited Sample Size: Only four randomized controlled trials (RCTs) were included, which raises concerns about the strength of the conclusions. This limitation should be emphasized more clearly in the discussion.

Response: inserted sentence in the discussion, directly pointing out this limitation.

 

1. Heterogeneity of Protocols: Although you mention the variability in protocols, it would strengthen the paper to include a more detailed exploration or possibly a sensitivity analysis (if feasible) or at least tabulate the variability (e.g., side-by-side comparison table).

Response: I apologize to the Reviewer, but I understand that this data is already presented in table 1.

 

1. Critical Appraisal of Evidence: The review largely summarizes findings without critically appraising the implications for clinical practice. For instance, what should clinicians take away, given the mixed bias levels and variability in studies?

Response: inserted sentence at the end of the discussion, regarding the clinical effect.

 

1. Figures and Tables: Ensure that figures (like the PRISMA diagram and risk-of-bias graphs) are polished for publication-quality clarity.

Response: the pictures have been improved, I hope they are adequate, but I am at your disposal for any other necessary changes.

 

1. Conclusion Section: Currently, the conclusion is cautious but very brief. You may expand it with practical recommendations and clear future research directions.

Response: added sentence indicating clinical use.

Reviewer 2 Report

Comments and Suggestions for Authors

I think that this  systematic review is well designed and interesting in its research question. The Discussion is well written and also provides mechanistic explanation of different modalities in treatment of vitiligo. However, I have few minor suggestions:

1. I think that the title should be more clear - in its current form, is hard to understand what did you compare in the study. Please, restate the title to be more clear and also correct this during the whole text (for example on the page 2, lines 78-81 - i.e. "We highlight the importance of a systematic literature review that analyzes the comparative efficacy of 308 nm excimer lamp therapy, narrowband UVB (NB-UVB), and 308 nm excimer laser in promoting repigmentation in patients with vitiligo."
2. Is the stating "excimer lamp/light therapy" really necessary or could only one word be used? I think it would be easier to read if only one word would be used.
3. On page 2, line 65 there is probably a mistake "to the size of the application point, which varies between 2 and 2cm".
4. On page 8, lines 254-255, I think the sentence needs to be restructered (With optimistic results regarding the technique despite the small number of studies included and possible biases.).
5. On page 8, line 286, there is a misspelling of interferon - IFN instead of INF.
6. Methods section could be rewritten in parts to be more clear and concise.

Author Response

I think that this  systematic review is well designed and interesting in its research question. The Discussion is well written and also provides mechanistic explanation of different modalities in treatment of vitiligo. However, I have few minor suggestions:

1. I think that the title should be more clear - in its current form, is hard to understand what did you compare in the study. Please, restate the title to be more clear and also correct this during the whole text (for example on the page 2, lines 78-81 - i.e. "We highlight the importance of a systematic literature review that analyzes the comparative efficacy of 308 nm excimer lamp therapy, narrowband UVB (NB-UVB), and 308 nm excimer laser in promoting repigmentation in patients with vitiligo."

Response: title changed to "Comparison".

 

1. Is the stating "excimer lamp/light therapy" really necessary or could only one word be used? I think it would be easier to read if only one word would be used.

Response: changed to just "lamp”

 

1. On page 2, line 65 there is probably a mistake "to the size of the application point, which varies between 2 and 2cm".

Response: I apologize for the mistake, and as there may be different equipment, beyond our knowledge, we have removed the area variation.

 

1. On page 8, lines 254-255, I think the sentence needs to be restructered (With optimistic results regarding the technique despite the small number of studies included and possible biases.).

Response: the sentence has been restructured.

 

1. On page 8, line 286, there is a misspelling of interferon - IFN instead of INF.

Response: the sentence has been restructured.

 

1. Methods section could be rewritten in parts to be more clear and concise.

Response: the sentences have been rewritten to make the information clearer.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Can be accepted in present form