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308-nm excimer laser for the treatment of psoriasis: a dose-response study.

Abstract

OBJECTIVE

To determine the dose-response relationship of excimer laser-generated 308-nm UV-B radiation for treating psoriasis.

DESIGN

Pilot study with a before-after design.

SETTING

A university dermatology service.

PATIENTS

Thirteen consecutive patients with at least 4 large, stable psoriasis plaques.

INTERVENTIONS

Excimer laser-generated 308-nm UV-B radiation was given to each of 4 plaques, which received 1, 2, 4, and 20 treatments, respectively. Untreated areas within each plaque served as controls. Within each plaque, 8 doses based on multiples of a predetermined minimal erythema dose (MED) were tested in distinct sites. The multiples were 0.5 and 1 (low dose); 2, 3, 4, and 6 (medium dose); and 8 and 16 (high dose). At every treatment, the dose for each site remained fixed at the same MED multiple. A psoriasis severity index score was determined for each area before, every 2 weeks during, and 2 and 4 months after treatment.

RESULTS

The mean+/-SD MED was 203.03+/-57.84 mJ/ cm2. Treatment with high fluences produced significantly better results than that with medium and low fluences at weeks 4, 6, 8, and 10 (P<.05). At 4 months' follow-up, all sites that received low or medium fluences had recurrences, whereas those that underwent a single treatment at 8 and 16 MED multiples remained in remission.

CONCLUSIONS

With 308-nm UV-B radiation generated by an excimer laser, it is possible to clear psoriasis with as little as 1 treatment with moderately long remission. In contrast to traditional phototherapy techniques, this handheld excimer laser UV-B therapy is selectively directed toward lesional skin, thus sparing the surrounding normal skin from unnecessary radiation exposure. Treatment of other inflammatory diseases and limited psoriasis seems reasonable to pursue with this modality.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.

    , ,

    Source

    Archives of dermatology 136:5 2000 May pg 619-24

    MeSH

    Dose-Response Relationship, Radiation
    Humans
    Laser Therapy
    Pilot Projects
    Psoriasis
    Severity of Illness Index
    Treatment Outcome
    Ultraviolet Therapy

    Pub Type(s)

    Clinical Trial
    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10815855

    Citation

    Asawanonda, P, et al. "308-nm Excimer Laser for the Treatment of Psoriasis: a Dose-response Study." Archives of Dermatology, vol. 136, no. 5, 2000, pp. 619-24.
    Asawanonda P, Anderson RR, Chang Y, et al. 308-nm excimer laser for the treatment of psoriasis: a dose-response study. Arch Dermatol. 2000;136(5):619-24.
    Asawanonda, P., Anderson, R. R., Chang, Y., & Taylor, C. R. (2000). 308-nm excimer laser for the treatment of psoriasis: a dose-response study. Archives of Dermatology, 136(5), pp. 619-24.
    Asawanonda P, et al. 308-nm Excimer Laser for the Treatment of Psoriasis: a Dose-response Study. Arch Dermatol. 2000;136(5):619-24. PubMed PMID: 10815855.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - 308-nm excimer laser for the treatment of psoriasis: a dose-response study. AU - Asawanonda,P, AU - Anderson,R R, AU - Chang,Y, AU - Taylor,C R, PY - 2000/5/18/pubmed PY - 2000/6/3/medline PY - 2000/5/18/entrez SP - 619 EP - 24 JF - Archives of dermatology JO - Arch Dermatol VL - 136 IS - 5 N2 - OBJECTIVE: To determine the dose-response relationship of excimer laser-generated 308-nm UV-B radiation for treating psoriasis. DESIGN: Pilot study with a before-after design. SETTING: A university dermatology service. PATIENTS: Thirteen consecutive patients with at least 4 large, stable psoriasis plaques. INTERVENTIONS: Excimer laser-generated 308-nm UV-B radiation was given to each of 4 plaques, which received 1, 2, 4, and 20 treatments, respectively. Untreated areas within each plaque served as controls. Within each plaque, 8 doses based on multiples of a predetermined minimal erythema dose (MED) were tested in distinct sites. The multiples were 0.5 and 1 (low dose); 2, 3, 4, and 6 (medium dose); and 8 and 16 (high dose). At every treatment, the dose for each site remained fixed at the same MED multiple. A psoriasis severity index score was determined for each area before, every 2 weeks during, and 2 and 4 months after treatment. RESULTS: The mean+/-SD MED was 203.03+/-57.84 mJ/ cm2. Treatment with high fluences produced significantly better results than that with medium and low fluences at weeks 4, 6, 8, and 10 (P<.05). At 4 months' follow-up, all sites that received low or medium fluences had recurrences, whereas those that underwent a single treatment at 8 and 16 MED multiples remained in remission. CONCLUSIONS: With 308-nm UV-B radiation generated by an excimer laser, it is possible to clear psoriasis with as little as 1 treatment with moderately long remission. In contrast to traditional phototherapy techniques, this handheld excimer laser UV-B therapy is selectively directed toward lesional skin, thus sparing the surrounding normal skin from unnecessary radiation exposure. Treatment of other inflammatory diseases and limited psoriasis seems reasonable to pursue with this modality. SN - 0003-987X UR - https://www.unboundmedicine.com/medline/citation/10815855/308_nm_excimer_laser_for_the_treatment_of_psoriasis:_a_dose_response_study_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/vol/136/pg/619 DB - PRIME DP - Unbound Medicine ER -