Successful Treatment of Granuloma Annulare with Thin-Layered Co2 Laser Ablation

Julian Penev,Ilko Bakardzhiev,Milla Balabanova

doi:10.15226/2378-1726/8/3/001140

Abstract

Two clinical cases of successful thin-layered CO2 laser ablation of localized form of granuloma annulare, are presented. Granuloma annulare is a rare dermatosis whose etiology is still unclear. Relation to various systemic diseases is assumed. Non-aesthetic lesions create discomfort, and may impede affected individuals’ social confidence, physical, and psycho-social functioning. In most cases lesions regress spontaneously, and therefore therapeutic minimalism is to be applied. Therapeutic modalities include laser therapy. Reports in literature of GA treatment with PDL, Fractional Thermolysis, as well as excimer laser indicate attempts at treatment of GA are being made not knowing the mechanisms behind etiology of GA. Presented bellow successfully treated cases with thin-layered CO2 laser ablation demonstrate treatment of GA with thin-layered laser ablation as therapeutically effective. The procedure is bloodless, relatively painless and completely aseptic, no postoperative pain. Possible impetiginization is easily avoided. Keywords: Granuloma Annulare; CO2 Laser; Thin-Layered Laser Ablation Abbreviations (CO2 laser) Carbon Dioxide Laser (GA) Granuloma Annulare (PDL) Pulsed Dye Laser (FT) Fractional Thermolysis

Highlights

Granuloma annulare is a rare dermatosis whose etiology has not so far been elucidated
The disease persists for years
Patients often suspect that this benign condition has not been properly diagnosed due to the fact that it is not amenable to therapy, and that impairs physician’s credibility

Summary

Introduction

Granuloma annulare is a rare dermatosis whose etiology has not so far been elucidated. First typical case presented is of a 60 years old female patient with GA for 10 years (Figure 1a) The patient reported she has previously been treated with injection and topical cream corticotherapy. The second case presented is of a 63 year old female patient with a 5 year old GA lesions on the right hand (Figure 3a). She reported, she has previously been unsuccessfully treated with topical steroid therapy. In both cases, a free hand laser thin-layered ablation technique was used, with a beam diameter of 1mm, power density of up to 600W/ cm, in superpulse mode.

Discussion

Conclusion