308-nm Excimer Laser for the Treatment of Psoriasis
Induration-Based Dosimetry
Atul Taneja, MD;
Manju Trehan, MD;
Charles R. Taylor, MD
Arch Dermatol. 2003;139:759-764.
Objective To determine the response of stubborn psoriatic plaques to the 308-nm excimer laser.
Design Controlled study with a before-after design.
Setting A university-based clinical research center.
Patients Adult subjects with recalcitrant plaque psoriasis that have not responded to other therapies for at least 2 months.
Interventions Selected psoriatic plaques were treated with the 308-nm excimer laser. One lesion was left as a control. Each plaque was treated 2 times a week, with an initial dose based solely on the induration component of the modified Psoriasis Area and Severity Index score for that lesion. Subsequent treatments were twice a week with dosage increments up to 50%, based on the change in induration. Four final consolidation doses were given once the induration score was reduced to zero.
Results Eighteen subjects were treated. There were 4 dropouts because of various scheduling problems. In the remaining 14 subjects, 44 plaques received a mean of 10 treatments (range, 4-14). Treatments were quick and well tolerated. The mean cumulative dose was 8.8 J/cm2 (range, 2.2-22.8 J/cm2). Compared with controls, treated plaques showed significant improvement (P<.001). The only adverse event was a mild sunburn-like reaction in 2 subjects after 1 treatment.
Conclusions Selective targeting of laser-generated 308-nm excimer radiation with this convenient subblistering dosage schedule based on induration allows for individualized treatment plans for each plaque. Clearing of stubborn psoriatic lesions occurs rapidly and safely.
From the Gange Photomedicine Research Center, Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston. The authors have no relevant financial interest in this article.
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