DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20190038

Comparative therapeutic evaluation of 308 nm monochromatic excimer light in combination with calcipotriol ointment vs 308 nm monochromatic excimer light alone in palmoplantar psoriasis

Chandrakant B. Poulkar, Nitin D. Chaudhari, Swapna S. Khatu, Shilpa L. Patwekar

Abstract


Background: Palmoplantar psoriasis is difficult to treat and often recalcitrant to traditional treatment modalities like topical steroids, anthralin, calcipotriol, methotrexate, cyclosporine, NB-UVB and PUVA. This study was aimed to compare efficacy of 308 nm monochromatic excimer light (MEL) in combination with calcipotriol ointment to 308 nm MEL alone in treatment of palmoplantar psoriasis.

Methods: This self-control study was conducted in 30 patients of palmoplantar psoriasis. Right side was treated with 308 nm MEL, 2 times/week, at meantime calcipotriol ointment was applied externally, 2 times/day (treatment group); the left side was treated with 308 nm MEL alone, 2 times/week (control group). Erythema, scaling, induration and fissuring (ESIF) score and cumulative doses of 308 nm MEL were assessed before treatment and on weeks 2, 4 and 6 after initiation of treatment.

Results: All 30 patients completed the treatment. ESIF scores on week 2, week 4, and week 6 in treatment group were significantly lower than control group (p<0.01). The average cumulative MEL dose in treatment group at the end of trial was 8.12±1.72 J/cm2, which was significantly lower than in control group 12.76±1.92 J/cm2 (p<0.01).

Conclusions: Treatment of palmoplantar psoriasis with 308 nm MEL in combination with external application of calcipotriol ointment can improve long-term treatment efficacy, decrease cumulative doses, and adverse effects induced by MEL irradiations.


Keywords


Palmoplantar psoriasis, monochromatic excimer light, calcipotriol

Full Text:

PDF

References


Farber EM, Nall ML. Natural history of psoriasis in 5600 patients. Dermatologica. 1974;148:1-18.

Campolmi P, Mavilla L, Lotti TM, Rossi R, Brazzini B, Hercogava J, et al. 308 nm monochromatic excimer light for the treatment of palmoplantar psoriasis. In J Immunopathol Pharmacol. 2002;13:11–3.

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.

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

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;17:408–13.

Dam TN, Moller B, Hindkjaer J, Kragballe K. The vitamin D3 analog calcipotriol suppresses the number and antigen-presenting function of Langerhans cells in normal human skin. J Investig Dermatol Symp Proc. 1996;1:72-7.

Tang YJ, Xu WW, Liu XM, Zhang RZ, Xu CX, Xu B, et al. 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.

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;20:768-70.

Mudigonda T, Dabade TS, West CE, Feldman SR. Therapeutic modalities for localized psoriasis:308-nm UVB excimer laser versus nontargeted phototherapy. Cutis. 2012;90:149-54.

Taneja A, Trehan M, Taylor CR. 308-nm excimer laser for the treatment of psoriasis:in-duration-based dosimetry. Arch Dermatol. 2003;139:759-64.

Dam TN, Møller B, Hindkjaer J, Kragballe K. The vitamin D3 analog calcipotriol suppresses the number and antigen-presenting function of Langerhans cells in normal human skin. J Investig Dermatol Symp Proc. 1996;1:72-7.

Mudigonda T, Dabade TS, Feldman SR. A review of protocols for 308 nm excimer laser phototherapy in psoriasis. J Drugs Dermatol. 2012;11:92-7.