Excimer Laser (308nm)(For Professionals)

Presentation

-acts by inducing apoptosis of type T lymphocytes.

-advantage: selective action

-disadvantage: limited treatment surface and expensive

-indications:

• psoriasis :

1. we can combine the treatment with steroids and vitamin D derivatives.
2. treatment of the plantar type unsatisfactory

Psoriasis responsive to excimer laser treatment

• vitiligo:

1. doses of 50-200mJ/cm2 (small doses)
2. 2 treatment sessions per week for a maximum of 24 weeks (duration of up to 48 weeks if partial response)
3. well tolerated
4. effective except on the bony proeminences.
5. can be combined with topical calcineurin inhibitor; ineffective when combined with vitamin D derivatives.

• mycosis fongoïdes (CTCL):

1. T1 and T2 stages (non nodular forms)
2. its efficacy has been proven histologically
3. 11-21 sessions of treatment are needed.
4. alopecia areata (regrowth is observed in 40-60% of treated persons)
5. only effective in localised forms of the disease.

• erosive lichen planus? (ineffective according to presenter)

• atopic dermatitis:

1. only two polemical studies availables
2. controversial result according to present
3. no study comparing excimer laser with topical steroids available
4. post-inflammatory hypopigmentation:
5. few studies are available but likely to be effective as long as maintenance treatment sessions are done.

• white striae (no studies done since 2004…)

• the rest of the indications are controversial (acne, lichen planus) and ineffective according to the presenter.

–Conclusion: the treatment of vitiligo and CTCL is effective. It is less effective for psoriasis and very controversial for other indications.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of  information (French): Controverses au sujet du laser (Passeron T), Journées dermatologiques de Paris 2009