Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis
Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report...
Ausführliche Beschreibung
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| Autor*in: |
Taibjee, S.M. [verfasserIn] Cheung, S-T. [verfasserIn] Laube, S. [verfasserIn] |
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E-Artikel |
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| Erschienen: |
Oxford, UK: Blackwell Science Ltd ; 2005 |
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Online-Ressource |
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| Reproduktion: |
2005 ; Blackwell Publishing Journal Backfiles 1879-2005 |
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| Übergeordnetes Werk: |
In: British journal of dermatology - Oxford : Wiley-Blackwell, 1892, 153(2005), 5, Seite 0 |
| Übergeordnetes Werk: |
volume:153 ; year:2005 ; number:5 ; pages:0 |
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| DOI / URN: |
10.1111/j.1365-2133.2005.06827.x |
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NLEJ242102719 |
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| 100 | 1 | |a Taibjee, S.M. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis |
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| 520 | |a Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. | ||
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10.1111/j.1365-2133.2005.06827.x doi (DE-627)NLEJ242102719 DE-627 ger DE-627 rakwb Taibjee, S.M. verfasserin aut Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis Oxford, UK Blackwell Science Ltd 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| controlled trial Cheung, S-T. verfasserin aut Laube, S. verfasserin aut Lanigan, S.W. oth In British journal of dermatology Oxford : Wiley-Blackwell, 1892 153(2005), 5, Seite 0 Online-Ressource (DE-627)NLEJ24392786X (DE-600)2004086-6 1365-2133 nnns volume:153 year:2005 number:5 pages:0 http://dx.doi.org/10.1111/j.1365-2133.2005.06827.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 153 2005 5 0 |
| spelling |
10.1111/j.1365-2133.2005.06827.x doi (DE-627)NLEJ242102719 DE-627 ger DE-627 rakwb Taibjee, S.M. verfasserin aut Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis Oxford, UK Blackwell Science Ltd 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| controlled trial Cheung, S-T. verfasserin aut Laube, S. verfasserin aut Lanigan, S.W. oth In British journal of dermatology Oxford : Wiley-Blackwell, 1892 153(2005), 5, Seite 0 Online-Ressource (DE-627)NLEJ24392786X (DE-600)2004086-6 1365-2133 nnns volume:153 year:2005 number:5 pages:0 http://dx.doi.org/10.1111/j.1365-2133.2005.06827.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 153 2005 5 0 |
| allfields_unstemmed |
10.1111/j.1365-2133.2005.06827.x doi (DE-627)NLEJ242102719 DE-627 ger DE-627 rakwb Taibjee, S.M. verfasserin aut Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis Oxford, UK Blackwell Science Ltd 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| controlled trial Cheung, S-T. verfasserin aut Laube, S. verfasserin aut Lanigan, S.W. oth In British journal of dermatology Oxford : Wiley-Blackwell, 1892 153(2005), 5, Seite 0 Online-Ressource (DE-627)NLEJ24392786X (DE-600)2004086-6 1365-2133 nnns volume:153 year:2005 number:5 pages:0 http://dx.doi.org/10.1111/j.1365-2133.2005.06827.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 153 2005 5 0 |
| allfieldsGer |
10.1111/j.1365-2133.2005.06827.x doi (DE-627)NLEJ242102719 DE-627 ger DE-627 rakwb Taibjee, S.M. verfasserin aut Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis Oxford, UK Blackwell Science Ltd 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| controlled trial Cheung, S-T. verfasserin aut Laube, S. verfasserin aut Lanigan, S.W. oth In British journal of dermatology Oxford : Wiley-Blackwell, 1892 153(2005), 5, Seite 0 Online-Ressource (DE-627)NLEJ24392786X (DE-600)2004086-6 1365-2133 nnns volume:153 year:2005 number:5 pages:0 http://dx.doi.org/10.1111/j.1365-2133.2005.06827.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 153 2005 5 0 |
| allfieldsSound |
10.1111/j.1365-2133.2005.06827.x doi (DE-627)NLEJ242102719 DE-627 ger DE-627 rakwb Taibjee, S.M. verfasserin aut Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis Oxford, UK Blackwell Science Ltd 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| controlled trial Cheung, S-T. verfasserin aut Laube, S. verfasserin aut Lanigan, S.W. oth In British journal of dermatology Oxford : Wiley-Blackwell, 1892 153(2005), 5, Seite 0 Online-Ressource (DE-627)NLEJ24392786X (DE-600)2004086-6 1365-2133 nnns volume:153 year:2005 number:5 pages:0 http://dx.doi.org/10.1111/j.1365-2133.2005.06827.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 153 2005 5 0 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">NLEJ242102719</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20210707150143.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">120427s2005 xx |||||o 00| ||und c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1111/j.1365-2133.2005.06827.x</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)NLEJ242102719</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Taibjee, S.M.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Oxford, UK</subfield><subfield code="b">Blackwell Science Ltd</subfield><subfield code="c">2005</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">z</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zu</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. 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Taibjee, S.M. |
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controlled study of excimer and pulsed dye lasers in the treatment of psoriasis |
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Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis |
| abstract |
Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. |
| abstractGer |
Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. |
| abstract_unstemmed |
Background and objectives The excimer laser delivers high energy monochromatic ultraviolet (UV) B at 308 nm. Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). CRT was also significantly greater for PDL than SA alone (P = 0·004) or untreated control (P =0·002). Nine (41%) patients cleared with excimer, after mean 8·7, median 10 weeks treatment. Seven of these nine patients were followed up to 1 year; four remained clear, two relapsed at 1 month, and one at 6 months. Six (27%) patients cleared with PDL, after mean 3·3, median four treatments. All six patients were followed up to 1 year; four remained clear, one relapsed at 4 months and one at 9 months. Despite common side-effects including blistering and hyperpigmentation, patient satisfaction was high. Serial images obtained with the SIAscope® during treatment indicated different mechanisms of action of the two lasers.Conclusions Excimer and V Beam® PDL are useful treatments for plaque psoriasis. Although the excimer appears to be on average more efficacious, a subset of patients may respond better to PDL. Long-term remission is achievable with both lasers. |
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Advantages over conventional UV sources include targeting of lesional skin, reducing cumulative dose and inducing faster clearance. Studies of the pulsed dye laser (PDL) in psoriasis report between 57% and 82% response rates; remission may extend to 15 months. To our knowledge, this is the first study assessing both excimer and PDL in psoriasis.Methods We conducted a within-patient controlled prospective trial of treatment of localized plaque psoriasis. Twenty-two adult patients, mean Psoriasis Area and Severity Index 7·1, were recruited. Fifteen patients completed the full treatment, of which 13 were followed up to 1 year. Two selected plaques were treated with excimer twice weekly and V Beam® PDL, pretreated with salicylic acid (SA), every 4 weeks, respectively. Two additional plaques, treated with SA alone or untreated, served as controls. The primary outcome measures were: (i) changes in plaque-modified Psoriasis Activity and Severity Index (PSI) scores from baseline to end of treatment; (ii) clinical response to treatment (CRT), assessed by serial photographs; (iii) percentage of plaques clear at the end of treatment; and (iv) percentage of plaques clear at 1-year follow-up. The secondary outcome measures were: (i) number of laser treatments to clearance; (ii) time to relapse; (iii) frequency of side-effects; and (iv) qualitative observations with SIAscope®.Results The mean improvement in PSI was 4·7 (SD 2·1) with excimer and 2·7 (SD 2·4) with PDL. PSI improvement was significantly greater in excimer than PDL (P = 0·003) or both control plaques (P < 0·001). CRT indicated 13 patients responded best with excimer, two patients best with PDL, and in seven patients there was no difference between the two lasers. CRT was significantly greater for excimer than PDL (P = 0·003) or both controls (P < 0·001). 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