Excimer laser for psoriasis treatment: A case report and short review

Valeriu Ardeleanu, Diana Sabina Radaschin, Alin Laurentiu Tatu, Valeriu Ardeleanu, Diana Sabina Radaschin, Alin Laurentiu Tatu

Abstract

Psoriasis is a common cutaneous disease that has major implications in the quality of life of the patient. It is characterised by a chronic course and in some subtypes, it can be life threatening. Many studies have focused on the pathogenesis concerning this disease therefore improving the therapeutic approaches. Phototherapy represents a well-known treatment option for psoriasis. The depletion of T cells mostly from the epidermis, after exposure to phototherapy, validates the role of this treatment. The 308 nm excimer laser has the ability to treat mild, moderate and even severe but localised psoriasis plaques and plays an important role in the treatment management of psoriasis. In this report, we present the case of a patient diagnosed with plaque psoriasis, resistant to topical ointments, successfully treated with the 308 nm excimer laser. Although further studies are still required to consider the 308 nm excimer laser as a first line therapy, its high response rates have significantly influenced the therapeutic approach in psoriasis.

Keywords: UVB 308 nm; decreased proliferation rate; excimer laser; lymphocytic apoptosis; psoriasis.

Copyright: © Ardeleanu et al.

Figures

Figure 1
Figure 1
Plaque type psoriasis on the left elbow prior to treatment with excimer laser.
Figure 2
Figure 2
Plaque type psoriasis on the left elbow after 5 weeks of treatment with excimer laser.

References

    1. International Federation of Psoriasis Associations: World Psoriasis Day, 2015. . Accessed June 27, 2019.
    1. Griffiths CEM, van der Walt JM, Ashcroft DM, Flohr C, Naldi L, Nijsten T, Augustin M. The global state of psoriasis disease epidemiology: A workshop report. Br J Dermatol. 2017;177:e4–e7. doi: 10.1111/bjd.15610.
    1. Bolognia J, Jorizzo JL and Schaffer JV (eds): Dermatology. Elsevier Saunders, Philadelphia, PA, 2012.
    1. Ayala-Fontánez N, Soler DC, McCormick TS. Current knowledge on psoriasis and autoimmune diseases. Psoriasis (Auckl) 2016;6:7–32. doi: 10.2147/PTT.S64950.
    1. McFadden J, Valdimarsson H, Fry L. Cross-reactivity between streptococcal M surface antigen and human skin. Br J Dermatol. 1991;125:443–447. doi: 10.1111/j.1365-2133.1991.tb14769.x.
    1. Narang T, Dogra S, Kaur I, Kanwar AJ. Malassezia and psoriasis: Koebner's phenomenon or direct causation? J Eur Acad Dermatol Venereol. 2007;21:1111–1112. doi: 10.1111/j.1468-3083.2006.02097.x.
    1. Enerbäck C, Martinsson T, Inerot A, Wahlström J, Enlund F, Yhr M, Swanbeck G. Evidence that HLA-Cw6 determines early onset of psoriasis, obtained using sequence-specific primers (PCR-SSP) Acta Derm Venereol. 1997;77:273–276. doi: 10.2340/0001555577273276.
    1. Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmun Rev. 2014;13:490–495. doi: 10.1016/j.autrev.2014.01.008.
    1. Spencer JM, Hadi SM. The excimer lasers. J Drugs Dermatol. 2004;3:522–525.
    1. Mehraban S, Feily A. 308 nm excimer laser in dermatology. J Lasers Med Sci. 2014;5:8–12.
    1. Mavilia L, Mori M, Rossi R, Campolmi P, Puglisi Guerra A, Lotti T. 308 nm monochromatic excimer light in dermatology: Personal experience and review of the literature. G Ital Dermatol Venereol. 2008;143:329–337.
    1. Morita A, Weiss M, Maeda A. Recent developments in phototherapy: Treatment methods and devices. Recent Pat Inflamm Allergy Drug Discov. 2008;2:105–108. doi: 10.2174/187221308784543665.
    1. Abrouk M, Levin E, Brodsky M, Gandy JR, Nakamura M, Zhu TH, Farahnik B, Koo J, Bhutani T. Excimer laser for the treatment of psoriasis: safety, efficacy, and patient acceptability. Psoriasis (Auckl) 2016;6:165–173. doi: 10.2147/PTT.S105047.
    1. Taneja A, Trehan M, Taylor CR. 308-nm excimer laser for the treatment of psoriasis: Induration-based dosimetry. Arch Dermatol. 2003;139:759–764. doi: 10.1001/archderm.139.6.759.
    1. Mudigonda T, Dabade TS, Feldman SR. A review of protocols for 308 nm excimer laser phototherapy in psoriasis. J Drugs Dermatol. 2012;11:92–97.
    1. Kemény L, Bónis B, Dobozy A, Bor Z, Szabó G, Ignácz F. 308-nm excimer laser therapy for psoriasis. Arch Dermatol. 2001;137:95–96.
    1. Tatu AL, Ciobotaru OR, Miulescu M, Buzia OD, Elisei AH, Mardarea N, Diaconu C, Robu S, Nwabudike LC. Hydrochlorothiazide: Chemical structure, therapeutic, phototoxic and carcinogenetic effects in dermatology Rev. Chim. 2018;69:2110–2114.
    1. Nwabudike LC, Tatu AL. Response to - chronic exposure to tetracyclines and subsequent diagnosis for non-melanoma skin cancer in a large Mid-Western US population. J Eur Acad Dermatol Venereol. 2018;32:e159–e159. doi: 10.1111/jdv.14657.
    1. Tatu AL, Ionescu MA, Nwabudike LC. Contact allergy to topical momethasone furoate confirmed by rechallenge and patch test. Am J Ther. 2018;25:e497–e498. doi: 10.1097/MJT.0000000000000581.
    1. Gheorghe I, Tatu AL, Lupu I, Thamer O, Cotar AI, Pircalabioru GG, Popa M, Cristea VC, Lazar V, Chifiriuc MC. Molecular characterization of virulence and resistance features in Staphylococcus aureus clinical strains isolated from cutaneous lesions in patients with drug adverse reactions. Rom Biotechnol Lett. 2017;22:12321–12327.
    1. Tatu AL, Nwabudike LC. Reply to: Kubiak K, et al: Endosymbiosis and its significance in dermatology. J Eur Acad Dermatol Venereol. 2018;32:e346–e347. doi: 10.1111/jdv.14921.
    1. Tatu AL, Cristea VC. Pityriasis folliculorum of the back thoracic area: Pityrosporum, keratin plugs, or Demodex involved? J Cutan Med Surg. 2017;21(441) doi: 10.1177/1203475417711114.
    1. Buzia OD, Fasie V, Mardare N, Diaconu C, Gurau G, Tatu AL. Formulation, preparation, physico-chimical analysis, microbiological peculiarities and therapeutic challenges of extractive solution of Kombucha. Rev Chim. 2018;69:720–724.
    1. Tatu AL, Cristea VC. Unilateral blepharitis with fine follicular scaling. J Cutan Med Surg. 2017;21(442) doi: 10.1177/1203475417711124.
    1. Irimie M, Oanţă A, Irimie CA, Fekete LG, Minea DI, Pascu A. Cardiovascular risk factors in patients with chronic plaque psoriasis: A case-control study on the Brasov County population. Acta Dermatovenerol Croat. 2015;23:28–35.
    1. Nwabudike LC, Tatu AL. Using complementary and alternative medicine for the treatment of psoriasis: A step in the right direction. JAMA Dermatol. 2019;155(636) doi: 10.1001/jamadermatol.2018.5346.
    1. Nwabudike LC, Tatu AL. Response to: Murphy EC, Nussbaum D, Prussick R, Friedman AJ. Use of complementary and alternative medicine by patients with psoriasis. J Am Acad Dermatol. 2019;81(e105) doi: 10.1016/j.jaad.2019.05.103.
    1. Modrigan M, Draganescu M, Condratovici CP, Pavel LL, Condratovici AP. Clinical personality patterns in young adults with HIV nosocomial infection from the region of Southeast Romania Mater. Plast. 2017;54:175–179.
    1. Batani A, Brănișteanu DE, Ilie MA, Boda D, Ianosi S, Ianosi G, Caruntu C. Assessment of dermal papillary and microvascular parameters in psoriasis vulgaris using in vivo reflectance confocal microscopy. Exp Ther Med. 2018;15:1241–1246. doi: 10.3892/etm.2017.5542.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren