308-nm excimer laser in psoriasis vulgaris, scalp psoriasis, and palmoplantar psoriasis

Gattu, Shilpa; Rashid, RM; Wu, Jashin J.

doi:10.1111/j.1468-3083.2008.02942.x

Cited by 38 publications

(16 citation statements)

References 30 publications

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“…Gattu et al insists that excimer laser/light therapy may be a complement to NB-UVB if refractory lesions remained after whole-body NB-UVB therapy, although excimer therapy may not be a practical modality for extensive plaques that cover multiple larger areas [16].…”

Section: -Nm Flat-type Fluorescent Lampmentioning

confidence: 99%

Evolution of targeted phototherapy for psoriasis

Kawada¹

2013

Expert Review of Dermatology

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Psoriasis is a major inflammatory disorder in the dermatological field. Phototherapy is effective and safe for psoriasis vulgaris. Narrow-band ultraviolet (UV) B and psoralen plus UVA are known to be the common modality as conventional non-targeted phototherapy. Non-targeted phototherapy making unnecessary irradiation to the unaffected skin may cause long-term adverse effects of UV. Targeted phototherapies with advantages, for example, higher dosages for lesional skin, a rapid clearing and longer remission rates, have been developed. Targeted phototherapies are preferably used for childhood, palmoplantar psoriasis, scalp and nail psoriasis as well as refractory lesions remained after whole-body UV therapy. Light sources of targeted phototherapy include broad-band UVB, narrow-band UVB, 308-nm excimer laser and light, 307-nm excimer light and 312-nm flat-type fluorescent lamp. This comprehensive review focuses recent evolution of target phototherapy for the treatment of psosriasis.KEYWORDS: 308-nm excimer laser/light • 312-nm flat-type fluorescent lamp • broad-band UVB • narrow-band UVB • psoriasis vulgaris • targeted phototherapy

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Section: -Nm Flat-type Fluorescent Lampmentioning

confidence: 99%

Evolution of targeted phototherapy for psoriasis

Kawada¹

2013

Expert Review of Dermatology

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“…It avoids unnecessary UV‐exposure of non‐lesional skin and allows higher dosages for lesional skin what results in a more rapid clearing. Both seem to achieve comparable efficacy with lower investment costs for excimer light 2–5 …”

Section: Clinical Outcome Lesion a – 307 Nm‐excimer Light; Lesion Bmentioning

confidence: 99%

“…Both seem to achieve comparable efficacy with lower investment costs for excimer light. [2][3][4][5] We report a pilot trial in moderate plaque-type adult psoriasis patients using a newly developed 307 nm-excimer lamp compared to topical dithranol.…”

Section: Editormentioning

confidence: 99%

“…1 Moreover, pitting scars ⁄ ulcers and sclerosing panniculitis are reported to be correlated with pulmonary hypertension. 2,3 Recently, we have experienced several SSc cases accompanied with cobblestone appearance (CSA), a rare skin manifestation of SSc characterized by multiple and immovable small papules ⁄ nodules on the extremities due to lymphangiectasia caused by an obstruction of the lymphatic channels during the sclerosing process 4,5 (Fig. 1a-c).…”

Section: Clinical Significance Of Cobblestone Appearance On the Skin mentioning

confidence: 99%

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Targeted 307 nm UVB‐excimer light vs. topical dithranol in psoriasis

Wollina

Koch

Scheibe

et al. 2011

Acad Dermatol Venereol

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EditorPhoto(chemo)therapy is a well established psoriasis therapy. As demonstrated by Parrish and Jaenicke, the action spectrum for psoriasis clearing is 300-313 nm. 1 In recent years, targeted UVB phototherapy with 308 nm-excimer laser and excimer light has been developed. It avoids unnecessary UV-exposure of non-lesional skin and allows higher dosages for lesional skin what results in a more rapid clearing. Both seem to achieve comparable efficacy with lower investment costs for excimer light. [2][3][4][5] We report a pilot trial in moderate plaque-type adult psoriasis patients using a newly developed 307 nm-excimer lamp compared to topical dithranol.This is an open clinical pilot trial with permission from the local ethical committee. Every patient served as his ⁄ her own control. Systemic therapy was not allowed. Two target lesions of comparable size and plaque-modified Psoriasis Activity and Severity Index (PSI) scores 6 were selected for monitoring. Lesion A was treated with 307 nm-excimer light only. Lesion B was treated with dithranol.Targeted UVB treatment was performed with a new device three times starting with the minimal erythema dose (MED). The mean 307 nm-excimer light exposure per session was 20 s resulting in a mean total irradiation time of 37 s. With the support of a quartz bar targeted treatment with a focus area of 3 cm 2 is realized. The average UVB med irradiance was 18 mW ⁄ cm 2 , maximum 20 mW ⁄ cm 2 . The average total energy applied was 2.05 J, with 1.13 J in the UVB med range. We used the fluorescence-remission imaging (FRIS) as described before 7 for non-invasive objective measurements.A total of 21 patients were recruited with 19 patients completing the investigation [15 men, six women]. The mean age was 51 years (range 26-84 years). All patients had a Fitzpatrick skin phototype II or III. The mean improvement of the PSI score was 3.0 for lesion A (three times excimer light) and for lesion B (twice daily dithranol) (P = 0.965; Mann-Whitney U-test). The results clearly demonstrate an equipotency of the targeted phototherapy to topical dithranol (Table 1).Tolerance was superior with targeted phototherapy. The most common adverse effect in excimer light-treated lesions was a mild to moderate erythema (n = 11), temporary blistering (n = 3), but there was no scarring or oozing. The NADH-fluorescence is reduced in psoriatic lesions. Excimer light treatment results in a normalization of NADH-fluorescence in contrast to dithranol.The UVB-excimer lamps are an alternative for targeted UVBtherapy in psoriasis. They seem to be as effective as non-targeted narrow-band UVB and 308 nm-excimer laser therapy. 4,5 There has been no study comparing targeted UVB phototherapy with topical treatments. In this study for the first time 307 nm-excimer light therapy was compared to topical dithranol therapy. Dithranol is one of the most potent topical antipsoriatic drugs. 8 We used a newly developed 307 nm-excimer light for targeted UVB-therapy and compared its efficacy and safety to topical dithranol twice d...

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“…Die gezielte UVB-Therapie ("targeted light therapy") hat sich insbesondere für die Psoriasis in den letzten Jahren etabliert [9,16,29,37]. Unsere Arbeitsgruppe konnte erstmals in Dosis-WirkungsStudien die notwendigen individuellen Bestrahlungsdosen beschreiben, und wir nannten die Dosis, die in der entzündeten ("inflammatory") Haut ein Erythem hinterlässt, MEDI [10].…”

Section: Diskussionunclassified

Targeted UVB-308 nm (NUVB) therapy with excimer laser in the treatment of atopic dermatitis and other inflammatory dermatoses

2009

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UVB 311 nm phototherapy (NUVB) is used successfully in the treatment of psoriasis or atopic dermatitis and is often chosen as "first-line" therapy. In a prospective study we investigated the efficacy of the targeted UVB 308 phototherapy by excimer laser in the treatment of 57 patients with localized, mild therapy-resistant atopic dermatitis. We achieved a complete remission (CR) in nearly 85% and a partial remission (PR) in 15% after 10 treatments during 6-8 weeks in all patients. A mean reduction in patient-reported pruritus was one hallmark after 3-4 treatments. 48 other patients with lichen simplex chronicus Vidal, nodular prurigo, granuloma anulare, alopezia areata (AA) and lichen ruber planus were also treated by targeted NUVB. We found higher rates of CR and PR only in patients with AA and in patients with oral Lichen ruber mucosae. These results and the systematically reviewing of the current medical literature shows that targeted NUVB by excimer laser cannot be successfully transferred for all inflammatory skin diseases. In particular, Excimer UVB treatment expands the therapeutic options in patients with localized and therapy-resistant atopic dermatitis enormously.

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308-nm excimer laser in psoriasis vulgaris, scalp psoriasis, and palmoplantar psoriasis

Abstract: Excimer is a useful and effective treatment for psoriasis that may be used as a compliment to topical medications as well as NB-UVB. However, large randomized trials with long-term follow-up are needed to further support this.

Cited by 38 publications

References 30 publications

Evolution of targeted phototherapy for psoriasis

Evolution of targeted phototherapy for psoriasis

Targeted 307 nm UVB‐excimer light vs. topical dithranol in psoriasis

Targeted UVB-308 nm (NUVB) therapy with excimer laser in the treatment of atopic dermatitis and other inflammatory dermatoses

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