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Laser Therapy in Psoriasis

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Advances in Psoriasis

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Abstract

Treatment options for psoriasis are numerous and span a wide array of modalities. For mild-to-moderate disease, topical therapy may be adequate for complete control; however, moderate-to-severe disease often requires systemic agents or phototherapy. Laser therapy is also a helpful tool in the armamentarium against psoriasis. For localized disease that is not adequately controlled with topicals or for lesions in difficult-to-treat areas, laser therapy may be an ideal treatment option. Lasers enable the delivery of therapeutic radiation to lesional skin only, thus sparing non-lesional skin from any possible adverse events. Over the past few decades, various lasing devices have been demonstrated to be safe and effective treatment options for psoriasis. The most commonly used devices include the 308-nm excimer laser and the 585 or 595-nm pulsed dye laser. Despite recent advances in targeted biologic therapy, lasers continue to play an important role in the management of psoriatic disease.

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References

  1. Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–6.

    Article  PubMed  Google Scholar 

  2. Bonis B, Kemeny L, Dobozy A, Bor Z, Szabo G, Ignacz F. 308 nm uvb excimer laser for psoriasis. Lancet. 1997;350(9090):1522.

    Article  CAS  PubMed  Google Scholar 

  3. Wong T, Hsu L, Liao W. Phototherapy in psoriasis: a review of mechanisms of action. J Cutan Med Surg. 2013;17(1):6–12.

    Article  CAS  PubMed  Google Scholar 

  4. Bianchi B, Campolmi P, Mavilia L, Danesi A, Rossi R, Cappugi P. Monochromatic excimer light (308 nm): an immunohistochemical study of cutaneous t cells and apoptosis-related molecules in psoriasis. J Eur Acad Dermatol Venereol. 2003;17(4):408–13.

    Article  CAS  PubMed  Google Scholar 

  5. Trehan M, Taylor CR. Medium-dose 308-nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol. 2002;47(5):701–8.

    Article  PubMed  Google Scholar 

  6. Trehan M, Taylor CR. High-dose 308-nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol. 2002;46(5):732–7.

    Article  PubMed  Google Scholar 

  7. Feldman SR, Mellen BG, Housman TS, Fitzpatrick RE, Geronemus RG, Friedman PM, Vasily DB, Morison WL. Efficacy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. J Am Acad Dermatol. 2002;46(6):900–6.

    Article  PubMed  Google Scholar 

  8. Gerber W, Arheilger B, Ha TA, Hermann J, Ockenfels HM. Ultraviolet b 308-nm excimer laser treatment of psoriasis: a new phototherapeutic approach. Br J Dermatol. 2003;149(6):1250–8.

    Article  CAS  PubMed  Google Scholar 

  9. He YL, Zhang XY, Dong J, Xu JZ, Wang J. Clinical efficacy of a 308 nm excimer laser for treatment of psoriasis vulgaris. Photodermatol Photoimmunol Photomed. 2007;23(6):238–41.

    Article  PubMed  Google Scholar 

  10. Bae JM, Eun SH, Oh SH, Shin JH, Kang HY, Kim KH, Lee SC, Choi CW. The 308-nm excimer laser treatment does not increase the risk of skin cancer in patients with vitiligo: a population-based retrospective cohort study. Pigment Cell Melanoma Res. 2019;

    Google Scholar 

  11. Taneja A, Trehan M, Taylor CR. 308-nm excimer laser for the treatment of psoriasis: induration-based dosimetry. Arch Dermatol. 2003;139(6):759–64.

    Article  PubMed  Google Scholar 

  12. Debbaneh MG, Levin E, Sanchez Rodriguez R, Leon A, Koo J, Rosenblum MD. Plaque-based sub-blistering dosimetry: reaching pasi-75 after two treatments with 308-nm excimer laser in a generalized psoriasis patient. J Dermatolog Treat. 2015;26(1):45–8.

    Article  CAS  PubMed  Google Scholar 

  13. Kagen M, Cao LY, Oyetakin-White P, Tacastacas JD, Yan C, McCormick TS, Cooper KD. Single administration of lesion-limited high-dose (turbo) ultraviolet b using the excimer laser: clinical clearing in association with apoptosis of epidermal and dermal t cell subsets in psoriasis. Photodermatol Photoimmunol Photomed. 2012;28(6):293–8.

    Article  CAS  PubMed  Google Scholar 

  14. Asawanonda P, Anderson RR, Chang Y, Taylor CR. 308-nm excimer laser for the treatment of psoriasis: a dose-response study. Arch Dermatol. 2000;136(5):619–24.

    Article  CAS  PubMed  Google Scholar 

  15. Housman TS, Pearce DJ, Feldman SR. A maintenance protocol for psoriasis plaques cleared by the 308 nm excimer laser. J Dermatolog Treat. 2004;15(2):94–7.

    Article  PubMed  Google Scholar 

  16. Fumimori T, Tsuruta D, Kawakami T, Ohata C, Furumura M, Hashimoto T. Effect of monochromatic excimer light on palmoplantar pustulosis: a clinical study performed in a private clinic by a dermatological specialist. J Dermatol. 2013;40(12):1004–7.

    Article  PubMed  Google Scholar 

  17. Furuhashi T, Torii K, Kato H, Nishida E, Saito C, Morita A. Efficacy of excimer light therapy (308 nm) for palmoplantar pustulosis with the induction of circulating regulatory t cells. Exp Dermatol. 2011;20(9):768–70.

    Article  CAS  PubMed  Google Scholar 

  18. Iga N, Otsuka A, Tanioka M, Miyachi Y, Kabashima K. Improvement of anti-tnf-alpha antibody-induced palmoplantar pustular psoriasis using a 308-nm excimer light. Case Rep Dermatol. 2012;4:261–4.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Carrascosa JM, Soria X, Domingo H, Ferrandiz C. Treatment of inverse psoriasis with excimer therapy and tacrolimus ointment. Dermatol Surg. 2007;33(3):361–3.

    CAS  PubMed  Google Scholar 

  20. Mafong EA, Friedman PM, Kauvar AN, Bernstein LJ, Alexiades-Armenakas M, Geronemus RG. Treatment of inverse psoriasis with the 308 nm excimer laser. Dermatol Surg. 2002;28(6):530–2.

    PubMed  Google Scholar 

  21. Al-Mutairi N, Al-Haddad A. Targeted phototherapy using 308 nm xecl monochromatic excimer laser for psoriasis at difficult to treat sites. Lasers Med Sci. 2013;28(4):1119–24.

    Article  PubMed  Google Scholar 

  22. Morison WL, Atkinson DF, Werthman L. Effective treatment of scalp psoriasis using the excimer (308 nm) laser. Photodermatol Photoimmunol Photomed. 2006;22(4):181–3.

    Article  PubMed  Google Scholar 

  23. Goldberg DJ, Chwalek J, Hussain M. 308-nm excimer laser treatment of palmoplantar psoriasis. J Cosmet Laser Ther. 2011;13(2):47–9.

    Article  PubMed  Google Scholar 

  24. Han L, Somani AK, Huang Q, Fang X, Jin Y, Xiang LH, Zheng ZZ. Evaluation of 308-nm monochromatic excimer light in the treatment of psoriasis vulgaris and palmoplantar psoriasis. Photodermatol Photoimmunol Photomed. 2008;24(5):231–6.

    Article  PubMed  Google Scholar 

  25. Nistico SP, Saraceno R, Stefanescu S, Chimenti S. A 308-nm monochromatic excimer light in the treatment of palmoplantar psoriasis. J Eur Acad Dermatol Venereol. 2006;20(5):523–6.

    Article  CAS  PubMed  Google Scholar 

  26. Neumann NJ, Mahnke N, Korpusik D, Stege H, Ruzicka T. Treatment of palmoplantar psoriasis with monochromatic excimer light (308-nm) versus cream puva. Acta Derm Venereol. 2006;86(1):22–4.

    CAS  PubMed  Google Scholar 

  27. Pahlajani N, Katz BJ, Lozano AM, Murphy F, Gottlieb A. Comparison of the efficacy and safety of the 308 nm excimer laser for the treatment of localized psoriasis in adults and in children: a pilot study. Pediatr Dermatol. 2005;22(2):161–5.

    Article  PubMed  Google Scholar 

  28. Tang YJ, Xu WW, Liu XM, Zhang RZ, Xu CX, Xu B, Cheng S, Liu Q. Self-control study of combination treatment of 308 nm excimer laser and calcipotriene ointment on stable psoriasis vulgaris. Int J Clin Exp Med. 2014;7(9):2844–50.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Dong J, He Y, Zhang X, Wang Y, Tian Y, Wang J. Clinical efficacy of flumetasone/salicylic acid ointment combined with 308-nm excimer laser for treatment of psoriasis vulgaris. Photodermatol Photoimmunol Photomed. 2012;28(3):133–6.

    Article  CAS  PubMed  Google Scholar 

  30. Levin E, Nguyen CM, Danesh MJ, Beroukhim K, Leon A, Koo J. An open label pilot study of supraerythemogenic excimer laser in combination with clobetasol spray and calcitriol ointment for the treatment of generalized plaque psoriasis. J Dermatolog Treat. 2016;27(3):210–3.

    Article  CAS  PubMed  Google Scholar 

  31. Trott J, Gerber W, Hammes S, Ockenfels HM. The effectiveness of puva treatment in severe psoriasis is significantly increased by additional uv 308-nm excimer laser sessions. Eur J Dermatol. 2008;18(1):55–60.

    CAS  PubMed  Google Scholar 

  32. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220(4596):524–7.

    Article  CAS  PubMed  Google Scholar 

  33. Hern S, Stanton AW, Mellor RH, Harland CC, Levick JR, Mortimer PS. In vivo quantification of the structural abnormalities in psoriatic microvessels before and after pulsed dye laser treatment. Br J Dermatol. 2005;152(3):505–11.

    Article  CAS  PubMed  Google Scholar 

  34. Noborio R, Kurokawa M, Kobayashi K, Morita A. Evaluation of the clinical and immunohistological efficacy of the 585-nm pulsed dye laser in the treatment of psoriasis. J Eur Acad Dermatol Venereol. 2009;23(4):420–4.

    Article  CAS  PubMed  Google Scholar 

  35. Zelickson BD, Mehregan DA, Wendelschfer-Crabb G, Ruppman D, Cook A, O’Connell P, Kennedy WR. Clinical and histologic evaluation of psoriatic plaques treated with a flashlamp pulsed dye laser. J Am Acad Dermatol. 1996;35(1):64–8.

    Article  CAS  PubMed  Google Scholar 

  36. Hern S, Allen MH, Sousa AR, Harland CC, Barker JN, Levick JR, Mortimer PS. Immunohistochemical evaluation of psoriatic plaques following selective photothermolysis of the superficial capillaries. Br J Dermatol. 2001;145(1):45–53.

    Article  CAS  PubMed  Google Scholar 

  37. Hern S, Stanton AW, Mellor RH, Harland CC, Levick JR, Mortimer PS. Blood flow in psoriatic plaques before and after selective treatment of the superficial capillaries. Br J Dermatol. 2005;152(1):60–5.

    Article  CAS  PubMed  Google Scholar 

  38. Hacker SM, Rasmussen JE. The effect of flash lamp-pulsed dye laser on psoriasis. Arch Dermatol. 1992;128(6):853–5.

    Article  CAS  PubMed  Google Scholar 

  39. Katugampola GA, Rees AM, Lanigan SW. Laser treatment of psoriasis. Br J Dermatol. 1995;133(6):909–13.

    Article  CAS  PubMed  Google Scholar 

  40. Ros AM, Garden JM, Bakus AD, Hedblad MA. Psoriasis response to the pulsed dye laser. Lasers Surg Med. 1996;19(3):331–5.

    Article  CAS  PubMed  Google Scholar 

  41. Ilknur T, Akarsu S, Aktan S, Ozkan S. Comparison of the effects of pulsed dye laser, pulsed dye laser + salicylic acid, and clobetasole propionate + salicylic acid on psoriatic plaques. Dermatol Surg. 2006;32(1):49–55.

    Article  CAS  PubMed  Google Scholar 

  42. Erceg A, Bovenschen HJ, van de Kerkhof PC, Seyger MM. Efficacy of the pulsed dye laser in the treatment of localized recalcitrant plaque psoriasis: a comparative study. Br J Dermatol. 2006;155(1):110–4.

    Article  CAS  PubMed  Google Scholar 

  43. Bjerring P, Zachariae H, Sogaard H. The flashlamp-pumped dye laser and dermabrasion in psoriasis—further studies on the reversed kobner phenomenon. Acta Derm Venereol. 1997;77(1):59–61.

    CAS  PubMed  Google Scholar 

  44. De Leeuw J, Van Lingen RG, Both H, Tank B, Nijsten T, Martino Neumann HA. A comparative study on the efficacy of treatment with 585 nm pulsed dye laser and ultraviolet b-tl01 in plaque type psoriasis. Dermatol Surg. 2009;35(1):80–91.

    PubMed  Google Scholar 

  45. de Leeuw J, Tank B, Bjerring PJ, Koetsveld S, Neumann M. Concomitant treatment of psoriasis of the hands and feet with pulsed dye laser and topical calcipotriol, salicylic acid, or both: a prospective open study in 41 patients. J Am Acad Dermatol. 2006;54(2):266–71.

    Article  PubMed  Google Scholar 

  46. Fernandez-Guarino M, Harto A, Sanchez-Ronco M, Garcia-Morales I, Jaen P. Pulsed dye laser vs. photodynamic therapy in the treatment of refractory nail psoriasis: a comparative pilot study. J Eur Acad Dermatol Venereol. 2009;23(8):891–5.

    Article  CAS  PubMed  Google Scholar 

  47. Oram Y, Karincaoglu Y, Koyuncu E, Kaharaman F. Pulsed dye laser in the treatment of nail psoriasis. Dermatol Surg. 2010;36(3):377–81.

    Article  CAS  PubMed  Google Scholar 

  48. Treewittayapoom C, Singvahanont P, Chanprapaph K, Haneke E. The effect of different pulse durations in the treatment of nail psoriasis with 595-nm pulsed dye laser: a randomized, double-blind, intrapatient left-to-right study. J Am Acad Dermatol. 2012;66(5):807–12.

    Article  PubMed  Google Scholar 

  49. Youssef NY, Saleh HM, Abdallah MA. Pulsed dye laser in the treatment of psoriatic nails: a controlled study. J Eur Acad Dermatol Venereol. 2017;31(1):e49–50.

    Article  CAS  PubMed  Google Scholar 

  50. Ruiz-Esparza J. Clinical response of psoriasis to low-energy irradiance with the nd:Yag laser at 1320 nm report of an observation in three cases. Dermatol Surg. 1999;25(5):403–7.

    Article  CAS  PubMed  Google Scholar 

  51. van Lingen RG, de Jong EM, van Erp PE, van Meeteren WS, van De Kerkhof PC, Seyger MM. Nd: Yag laser (1,064 nm) fails to improve localized plaque type psoriasis: a clinical and immunohistochemical pilot study. Eur J Dermatol. 2008;18(6):671–6.

    PubMed  Google Scholar 

  52. Kartal SP, Canpolat F, Gonul M, Ergin C, Gencturk Z. Long-pulsed nd: Yag laser treatment for nail psoriasis. Dermatol Surg. 2018;44(2):227–33.

    Article  CAS  PubMed  Google Scholar 

  53. Bekassy Z, Astedt B. Carbon dioxide laser vaporization of plaque psoriasis. Br J Dermatol. 1986;114(4):489–92.

    Article  CAS  PubMed  Google Scholar 

  54. Alora MB, Anderson RR, Quinn TR, Taylor CR. Co2 laser resurfacing of psoriatic plaques: a pilot study. Lasers Surg Med. 1998;22(3):165–70.

    Article  CAS  PubMed  Google Scholar 

  55. Asawanonda P, Anderson RR, Taylor CR. Pendulaser carbon dioxide resurfacing laser versus electrodesiccation with curettage in the treatment of isolated, recalcitrant psoriatic plaques. J Am Acad Dermatol. 2000;42(4):660–6.

    Article  CAS  PubMed  Google Scholar 

  56. Al-Mutairi N, Noor T, Al-Haddad A. Single blinded left-to-right comparison study of excimer laser versus pulsed dye laser for the treatment of nail psoriasis. Dermatol Ther (Heidelb). 2014;4(2):197–205.

    Article  Google Scholar 

  57. Taibjee SM, Cheung ST, Laube S, Lanigan SW. Controlled study of excimer and pulsed dye lasers in the treatment of psoriasis. Br J Dermatol. 2005;153(5):960–6.

    Article  CAS  PubMed  Google Scholar 

  58. Arango-Duque LC, Roncero-Riesco M, Usero Barcena T, Palacios Alvarez I, Fernandez LE. Treatment of nail psoriasis with pulse dye laser plus calcipotriol betametasona gel vs. Nd:Yag plus calcipotriol betamethasone gel: an intrapatient left-to-right controlled study. Actas Dermosifiliogr. 2017;108(2):140–4.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, University of California San Francisco, San Francisco, CA, USA

    Quinn Thibodeaux & John Koo

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  1. Quinn Thibodeaux
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  1. Department of Dermatology, Suite 11D, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Jeffrey M. Weinberg

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Mark Lebwohl

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Thibodeaux, Q., Koo, J. (2021). Laser Therapy in Psoriasis. In: Weinberg, J.M., Lebwohl, M. (eds) Advances in Psoriasis. Springer, Cham. https://doi.org/10.1007/978-3-030-54859-9_8

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  • DOI: https://doi.org/10.1007/978-3-030-54859-9_8

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