Plaque-based sub-blistering dosimetry: Reaching PASI-75 after two treatments with 308-nm excimer laser in a generalized psoriasis patient.

Abstract

BACKGROUND:

Generalized UVB phototherapy has been established as an effective and safe treatment for chronic plaque-type psoriasis for decades and in recent years, targeted 308-nm excimer laser has emerged as an equally safe and more effective treatment option. While traditional dosimetry for laser has been determined either through minimal erythema dose (MED) or a combination of the patient's Fitzpatrick skin type and the level of plaque induration, we have developed "Plaque-based Sub-blistering Dosimtery" based on observations that administering anywhere from 8 to 16 multiples of MED to psoriatic plaques has resulted in clearance after one treatment with longer remission rates than the traditional dosing protocol.

CASE REPORT:

The authors describe a case in which a patient achieved PASI 75 following only two treatments with 308 nm excimer laser using this new protocol. Biopsies taken before and after treatment reveal a dramatic decrease in CD4+T cells as well as TNF-alpha- and IL-2-producing T cells.

CONCLUSION:

This case demonstrates using a more aggressive dosing protocol determined by plaque testing is well-tolerated and can lead to excellent clearance with minimal side effects and comorbidity.

• Authors: Maya G Debbaneh, Ethan Levin, Robert Sanchez Rodriguez, Argentina Leon, John Koo, Michael D Rosenblum
• Journal: The Journal of dermatological treatment (J Dermatolog Treat) Vol. 26 Issue 1 Pg. 45-8 (Feb 2015) ISSN: 1471-1753 [Electronic] England
• PMID: 24552548 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Humans
• Lasers, Excimer (therapeutic use)
• Male
• Psoriasis (pathology, therapy)
• Severity of Illness Index
• Treatment Outcome
• Ultraviolet Therapy (methods)