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Excimer laser for the treatment of psoriasis: safety, efficacy, and patient acceptability

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      Abstract

      Introduction

      The 308 nm excimer laser is a widely used device throughout the field of dermatology for many diseases including psoriasis. Although the laser has demonstrated clinical efficacy, there is a lack of literature outlining the safety, efficacy, and patient acceptability of the excimer laser.

      Methods

      A literature search on PubMed was used with combinations of the terms “excimer”, “excimer laser”, “308 nm”, “psoriasis”, “protocol”, “safety”, “efficacy”, acceptability”, “side effects”, and “dose”. The search results were included if they contained information pertaining to excimer laser and psoriasis treatment and description of the safety, efficacy, and patient acceptability of the treatment.

      Results

      The 308 nm excimer laser is generally safe and well tolerated with minimal side effects including erythema, blistering, and pigmentary changes. It has a range of efficacies depending on the protocol used with several different treatment protocols, including the induration protocol, the minimal erythema dose protocol, and the newer minimal blistering dose protocol.

      Conclusion

      Although the excimer laser is not a first-line treatment, it remains an excellent treatment option for psoriasis patients and has been demonstrated to be an effective treatment with little to no side effects.

      Related collections

      Most cited references 41

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      Psoriasis.

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        Excimer laser surgery of the cornea.

        The excimer laser, which produces light in the far-ultraviolet portion of the spectrum, allows precise removal of corneal tissue through a photochemical laser-tissue interaction. This interaction is not thermal and does not involve optical breakdown; rather, it directly breaks organic molecular bonds without tissue heating. We used this process of ablative photodecomposition to remove corneal tissue in a series freshly enucleated cow eyes. Applying the far-ultraviolet light in short intense pulses permitted us to control the depth of the incision with great precision. We found that 1 joule/cm2 ablates corneal tissue to a depth of 1 micron. Adjacent tissue suffered no thermal damage and the stromal lamellae adjacent to the incision showed no evidence of disorganization.
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          Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 5. Guidelines of care for the treatment of psoriasis with phototherapy and photochemotherapy.

          Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this fifth of 6 sections of the guidelines of care for psoriasis, we discuss the use of ultraviolet (UV) light therapy for the treatment of patients with psoriasis. Treatment should be tailored to meet individual patients' needs. We will discuss in detail the efficacy and safety as well as offer recommendations for the use of phototherapy, including narrowband and broadband UVB and photochemotherapy using psoralen plus UVA, alone and in combination with topical and systemic agents. We will also discuss the available data for the use of the excimer laser in the targeted treatment of psoriasis. Finally, where available, we will summarize the available data that compare the safety and efficacy of the different forms of UV light therapy.
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            Author and article information

            Affiliations
            [1 ]Irvine School of Medicine, Irvine
            [2 ]Department of Dermatology, Psoriasis and Skin Treatment Center, University of California, San Francisco
            [3 ]Department of Dermatology, University of Southern California Keck School of Medicine, Los Angeles, CA
            [4 ]Department of Dermatology, University of Vermont College of Medicine, Burlington, VT, USA
            Author notes
            Correspondence: Michael Abrouk, 515 Spruce Street, San Francisco, CA 94118, USA, Tel +1 805 279 8755, Fax +1 415 502 4126, Email Michaelabrouk1@ 123456gmail.com
            Journal
            Psoriasis (Auckl)
            Psoriasis (Auckl)
            Psoriasis: Targets and Therapy
            Psoriasis (Auckland, N.Z.)
            Dove Medical Press
            2230-326X
            2016
            12 December 2016
            : 6
            : 165-173
            5683125 10.2147/PTT.S105047 ptt-6-165
            © 2016 Abrouk et al. This work is published and licensed by Dove Medical Press Limited

            The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

            Categories
            Review

            excimer, laser, 308 nm, psoriasis, safety, efficacy

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