Abstract
Background: Scalp psoriasis is usually refractory to treatment. Excimer devices have been proved to be a promising therapeutic option in psoriasis. Greater efficacy of phototherapy can be achieved by concurrent use of coal tar derivatives.Objective: We aimed to compare efficacy and safety between 308-nm excimer lamp monotherapy and a combination of 308-nm excimer lamp and 10% liquor carbonis detergens in the treatment of scalp psoriasis.Methods: In this randomized, evaluator-blinded, prospective, comparative study, 30 patients with scalp psoriasis received either 308-nm excimer lamp monotherapy or a combination of 308-nm excimer lamp and 10% liquor carbonis detergens twice per week until complete remission of the scalp or for a total of 30 sessions. Efficacy was evaluated by the improvement of Psoriasis Scalp Severity Index (PSSI) score, itch score, and Scalpdex score.Results: Both treatments induced significant improvement in PSSI score with greater reduction observed in the combination group. At 30th visit, a 75% reduction in PSSI (PSSI75) was attained by 4 (28.6%) and 9 (69.2%) patients treated with monotherapy and combination therapy, respectively (P < 0.05).Conclusions: Excimer lamp is well-tolerated in patients with scalp psoriasis and liquor carbonis detergens can be used as a combination therapy to improve the efficacy of excimer lamp.
Highlights
Psoriasis is a common dermatologic disease with a prevalence of ∼0.5–11% worldwide [1]. It has several clinical presentations which eventually develop into chronic plaque psoriasis
Thirty patients with clinically diagnosed plaque-type scalp psoriasis were enrolled in the study
Phototherapy interfered with antigen presentation of Langerhans cells to the T cell which in turn affects cytokines and adhesion molecules that are overexpressed in psoriatic plaques [16, 17]
Summary
Psoriasis is a common dermatologic disease with a prevalence of ∼0.5–11% worldwide [1]. Earlier studies found that 308nm excimer laser was able to achieve exceptional results in the previously recalcitrant area of the scalp [5,6,7]. A previous study using a 308-nm excimer lamp, a non-laser device, demonstrated a similar favorable result in the treatment of scalp psoriasis with minimal and transient side effects [8]. Comparing to the excimer laser, the excimer lamp has the superior advantage of being able to give uniform irradiation of 50 times wider area in a single exposure at a lower cost [9]. Greater efficacy of phototherapy can be achieved by concurrent use of coal tar derivatives
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