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Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study.

Abstract

OBJECTIVE

Our purpose was to demonstrate the efficacy of the 308-nm excimer laser for treatment of psoriasis.

METHODS

This study was a multicenter open trial from 5 dermatology practices (one university-based and 4 private practices). Up to 30 patients per center with stable mild to moderate plaque-type psoriasis constituted the study population. Patients received 308-nm ultraviolet B doses to affected areas. The initial dose was based on multiples of a predetermined minimal erythema dose. Subsequent doses were based on the response to treatment. Treatments were scheduled twice weekly for a total of 10 treatments. The main outcome measure was 75% clearing of the target plaque. Time to clearing was analyzed by Kaplan-Meier methods, accounting for truncated observations.

RESULTS

One hundred twenty-four patients were enrolled in the study, and 80 completed the entire protocol. The most common reason for exiting from the study was noncompliance. Of the patients who met the protocol requirements of 10 treatments or clearing, 72% (66/92) achieved at least 75% clearing in an average of 6.2 treatments. Eighty-four percent of patients (95% confidence interval [CI], 79%-87%) reached improvement of 75% or better after 10 or fewer treatments. Fifty percent of patients (95% CI, 35%-61%) reached improvement of 90% or better after 10 or fewer treatments. Common side effects included erythema, blisters, hyperpigmentation, and erosions, but they were well tolerated.

CONCLUSIONS

Monochromatic 308-nm excimer laser treatment appears to be effective and safe for psoriasis. It requires fewer patient visits than conventional phototherapy, and, unlike those treatments, the laser targets only the affected areas of the skin, sparing the surrounding uninvolved skin.

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  • Authors+Show Affiliations

    ,

    Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1071, USA. sfeldman@wfubmc.edu

    , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Aged
    California
    Child
    Child, Preschool
    Disease-Free Survival
    Female
    Humans
    Laser Therapy
    Male
    Maryland
    Middle Aged
    New York City
    North Carolina
    Pennsylvania
    Psoriasis
    Radiation Dosage
    Severity of Illness Index
    Treatment Outcome
    Ultraviolet Therapy

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    12063488

    Citation

    Feldman, Steven R., et al. "Efficacy of the 308-nm Excimer Laser for Treatment of Psoriasis: Results of a Multicenter Study." Journal of the American Academy of Dermatology, vol. 46, no. 6, 2002, pp. 900-6.
    Feldman SR, Mellen BG, Housman TS, et al. Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. J Am Acad Dermatol. 2002;46(6):900-6.
    Feldman, S. R., Mellen, B. G., Housman, T. S., Fitzpatrick, R. E., Geronemus, R. G., Friedman, P. M., ... Morison, W. L. (2002). Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. Journal of the American Academy of Dermatology, 46(6), pp. 900-6.
    Feldman SR, et al. Efficacy of the 308-nm Excimer Laser for Treatment of Psoriasis: Results of a Multicenter Study. J Am Acad Dermatol. 2002;46(6):900-6. PubMed PMID: 12063488.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. AU - Feldman,Steven R, AU - Mellen,Beverly G, AU - Housman,Tamara Salam, AU - Fitzpatrick,Richard E, AU - Geronemus,Roy G, AU - Friedman,Paul M, AU - Vasily,David B, AU - Morison,Warwick L, PY - 2002/6/14/pubmed PY - 2002/7/13/medline PY - 2002/6/14/entrez SP - 900 EP - 6 JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. VL - 46 IS - 6 N2 - OBJECTIVE: Our purpose was to demonstrate the efficacy of the 308-nm excimer laser for treatment of psoriasis. METHODS: This study was a multicenter open trial from 5 dermatology practices (one university-based and 4 private practices). Up to 30 patients per center with stable mild to moderate plaque-type psoriasis constituted the study population. Patients received 308-nm ultraviolet B doses to affected areas. The initial dose was based on multiples of a predetermined minimal erythema dose. Subsequent doses were based on the response to treatment. Treatments were scheduled twice weekly for a total of 10 treatments. The main outcome measure was 75% clearing of the target plaque. Time to clearing was analyzed by Kaplan-Meier methods, accounting for truncated observations. RESULTS: One hundred twenty-four patients were enrolled in the study, and 80 completed the entire protocol. The most common reason for exiting from the study was noncompliance. Of the patients who met the protocol requirements of 10 treatments or clearing, 72% (66/92) achieved at least 75% clearing in an average of 6.2 treatments. Eighty-four percent of patients (95% confidence interval [CI], 79%-87%) reached improvement of 75% or better after 10 or fewer treatments. Fifty percent of patients (95% CI, 35%-61%) reached improvement of 90% or better after 10 or fewer treatments. Common side effects included erythema, blisters, hyperpigmentation, and erosions, but they were well tolerated. CONCLUSIONS: Monochromatic 308-nm excimer laser treatment appears to be effective and safe for psoriasis. It requires fewer patient visits than conventional phototherapy, and, unlike those treatments, the laser targets only the affected areas of the skin, sparing the surrounding uninvolved skin. SN - 0190-9622 UR - https://www.unboundmedicine.com/medline/citation/12063488/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(02)70124-2 DB - PRIME DP - Unbound Medicine ER -