022 308 excimer laser treatment of psoriasis

Abstract

The excimer 308 nm laser has recently been FDA‐approved in the United States for the treatment of psoriasis. Our center was the first to study this device systematically for this indication. Investigations to date have included an initial dose‐response study, a high‐dose as well as a medium‐dose one. Collectively, these results were analyzed and remission periods were reviewed. The rapidity of clearing as well as the severity of side‐effects showed a clear dose‐response relationship. Even thick plaques responded. The treatment process itself is quick and painless, allowing the operator to cover a palm‐sized area in just a minute. The laser is easy to use and there are no disfiguring purpura. By selectively focusing on lesional skin, overall cutaneous ultraviolet burden is minimized. Localized tanning is another side‐effect to be anticipated. Obviously, blistering doses show limited applicability as the sole treatment for extensive disease. Moreover, the long‐term risks associated with blistering directly on plaques of psoriasis themselves, while not clearly established, seem unlikely to be favorable. On the other hand, sub‐blistering doses appear to be extremely well‐tolerated. Wound care, except in the cases of blistering doses, is minimal. In short, the 308 nm excimer laser offers a novel targeted treatment modality for localized psoriasis, even when the plaques are quite thick.