Pulsed dye laser versus treatment with calcipotriol/betamethasone dipropionate for localized refractory plaque psoriasis: Effects on T‐cell infiltration, epidermal proliferation and keratinization

Abstract

Background: Selective photothermolysis of diseased capillaries by pulsed dye laser (PDL) treatment has been described as a mechanism for long‐lasting clearance of psoriatic plaques. Aim: To evaluate PDL and a two‐compound formulation of calcipotriol/betamethasone dipropionate ointment for the treatment of localized, recalcitrant plaque psoriasis. Methods: Eight psoriatic patients were treated for 4 weeks with both PDL and topical calcipotriol/betamethasone dipropionate in an open, intra‐patient, left–right comparison. Biopsies were analyzed for T‐cell subsets, cells expressing NK‐receptors, epidermal proliferation, differentiation and epidermal thickness. Results: After active treatment, both treatments showed statistically significant but comparable improvements of T‐cell subsets, epidermal proliferation, differentiation and epidermal thickness. In line with the clinical results, after an 8‐week follow‐up period statistically significant further reductions were observed for dermal CD3+, CD4+, CD45RO+, CD2+ T cells, epidermal CD3+, CD8+, CD45RO+, CD2+, CD25+ T cells and the epidermal parameters for the PDL‐treated plaques, in contrast to the topically treated plaques. Conclusion: After 8 weeks of follow‐up, PDL treatment for localized and recalcitrant plaque psoriasis resulted in persistent reductions of activated and memory effector T‐helper cells in the dermis, cytotoxic T cells in the epidermis, and normalization of epidermal proliferation and keratinization, in contrast to treatment with calcipotriol/betamethasone dipropionate ointment.