Zusammenfassung
Die Therapie der Psoriasis gestaltet sich vielfach schwierig und stellt auch heute noch eine Herausforderung für den Dermatologen dar. Neben zahlreichen immunmodulierenden Therapieansätzen wurden zuletzt auch verschiedene Lasersysteme bei der chronischen Plaquepsoriasis eingesetzt. Es kamen hierbei der CO2-, der Er:YAG-, der Farbstoff-, der 1302-nm-Nd:YAG- und der Excimer-Laser zur Anwendung. Nach Durchsicht und kritischer Evaluation der bisher erschienenen Publikationen hat sich unserer Meinung nach der 308-nm-Excimer-Laser nicht nur gegenüber anderen Lasersystemen, sondern vor allem im Vergleich zur konventionellen 311-nm-Schmalband-UVB-Therapie bewährt. Er bietet eine effiziente und Erfolg versprechende Therapieoption bei der Behandlung unterschiedlicher Psoriasisformen.
Abstract
Treatment of psoriasis is often complicated and remains a challenge. Along with the many new immunomodulatory approaches, various laser systems have been employed in an attempt to treat chronic plaque psoriasis. These include CO2, Er:YAG , pulsed dye, 1302 nm Nd:YAG and excimer lasers. After reviewing and critically evaluating the literature, we conclude that the 308 nm excimer laser has proven its efficacy, not only in comparison with other laser systems, but also when compared with conventional 311 nm narrow-band UVB treatment. It is an efficient and promising therapeutic option for treating different forms of psoriasis.
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Literatur
Alora MBT, Anderson RR, Quinn TR, Taylor CR (1998) CO2 laser resurfacing of psoriatic plaques: a pilot study. Lasers Surg Med 165:165–170
Asawanonda P, Anderson RR, Chang Y, Taylor CR (2000) 308-nm excimer laser for the treatment of psoriasis. Arch Dermatol 136:619–624
Asawanonda P, Anderson RR, Taylor CR (2000) Pendular carbon dioxide resurfacing laser versus electrodesiccation with curettage in the treatment of isolated, recalcitrant psoriatic plaques. J Am Acad Dermatol 42:660–666
Békásy Z, Åstedt B (1986). Carbon dioxide laser vaporisation of plaque psoriasis. Br J Dermatol 114:489–492
Bjerring P, Zachariae H, Søgaard H (1997) The flashlamp-pumped dye laser and dermabrasion in psoriasis—further studies on the reversed Köbner Phenomenon. Acta Derm Vererol (Stockh) 77:59–61
Boehncke WH, Ochsendorf F, Wolter M, Kaufmann R (1999) Ablative techniques in psoriasis vulgaris resistant to conventional therapies. Dermatol Surg 25:618–621
Bónis B, Kemény L, Dobozy A et al. (1997) 308 nm UVB excimer laser for psoriasis. Lancet 350:1522
Feldman SR, Mellen BG, Housman TS et al. (2002). Efficiancy of the 308-nm excimer laser for treatment of psoriasis: results of a multicenter study. J Am Acad Dermatol 46:900–906
Hacker SM, Rasmusen JE (1992) The effect of flash lamp-pulsed dye laser on psoriasis. Arch Dermatol 128:853–855
Hellwig S, Petzoldt D, Raulin C (1997) Der gepulste Farbstofflaser—Möglichkeiten und Grenzen. Hautarzt 48:536–540
Heng MCY, Allen SG, Haberfelde GH, Song MK (1991) Electronmicroscopic and immunohistochemical studies of the sequence of events in psoriatic plaque formation following tape-stripping. Br J Dermatol 125:548–556
Hern S, Allen MH, Sousa AR et al. (2001). Immunohistochemical evaluation of psoriatic plaques following selective photothermolysis of the superficial capillaries. Br J Dermatol 145:45–53
Hull SM, Goodfield M, Wood EJ, Cunliffe WJ (1989) Active and inactive edges of psoriatic plaques: identification by tracing and investigation by laser-Doppler flowmetry and immunocytochemical techniques. J Invest Dermatol 92:782–785
Katugampola GA, Rees AM, Lanigan SW (1995) Laser treatment of psoriasis. Br J Dermatol 133:909–913
Kemény L, Bónis B, Dobrozy A, et al. (2001) 308-nm excimer laser therapy for psoriasis. Arch Dermatol 137:95
Mafong EA, Friedman PM, Kauvar ANB et al. (2002) Treatment of inverse psoriasis with the 308 nm excimer laser. Dermatol Surg 28:530–532
Novak Z, Bónis B, Baltas E et al. (2002) Xenon chloride ultraviolet B laser is more effective in treating psoriasis and in inducing T cell apoptosis than narrow-band ultraviolet B. J Photochem Photobiol 67:32–38
Parrish JA, Jaenicke KF (1981) Action spectrum for phototherapy of psoriasis. J Invest Dermatol 76:359–362
Ros AM, Garden JM, Bakus AD, Hedblad MA (1996) Psoriasis response to the pulsed dye laser. Lasers Surg Med 19:331–335
Ruiz-Esparza J (1999) Clinical response of psoriasis to low-energy irradiance with the Nd:YAG laser at 1320 nm. Dermatol Surg 25:403–407
Stern RS (2001) The risk of melanoma in association with long-term exposure to PUVA. J Am Acad Dermatol 44:755–761
Trehan M, Taylor CR (2002) High-dose 308-nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol 46:732–737
Tehan M, Taylor CR (2002) Medium-dose 308-nm excimer laser for the treatment of psoriasis. J Am Acad Dermatol 47:701–708
Yen A, Braverman IM (1976) Ultrastructure of the human microcirculation: the horizontal plexus of the papillary dermis. J Invest Dermatol 66:131–142
Zelickson BD, Mehregan DA, Wendelschfer-Crabb G et al. (1996) Clinical and histologic evaluation of psoriatic plaques treated with a flashlamp pulsed dye laser. J Am Acad Dermatol 35:64–68
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Raulin, C., Grema, H. Psoriasis vulgaris. Hautarzt 54, 242–247 (2003). https://doi.org/10.1007/s00105-003-0491-8
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DOI: https://doi.org/10.1007/s00105-003-0491-8