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

Pahlajani, N; Katz, Brian; Lozano, Ann Marie; Murphy, Francis; Gottlieb, Alice B.

doi:10.1111/j.1525-1470.2005.22216.x

Cited by 42 publications

(11 citation statements)

References 26 publications

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“…A pilot study has reported 308 nm excimer laser to be a safe and effective treatment for localized psoriasis in children as in adults. [64] CONCLUSION Childhood psoriasis represents a special challenge to dermatologists. Limited data suggests that psoriasis in Indian children differs from western countries in having a later onset, equal sex distribution, infrequent facial involvement, low frequency of guttate lesions, more frequent involvement of the soles, and a low incidence of familial occurrence.…”

Section: Phototherapymentioning

confidence: 98%

Childhood psoriasis

Dogra¹,

Kaur²

2010

Indian J Dermatol Venereol Leprol

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Psoriasis is a common dermatosis in children with about one third of all patients having onset of disease in the first or second decade of life. A chronic disfiguring skin disease, such as psoriasis, in childhood is likely to have profound emotional and psychological effects, and hence requires special attention. Psoriasis in children has been reported to differ from that among adults being more frequently pruritic; plaque lesions are relatively thinner, softer, and less scaly; face and flexural involvement is common and guttate type is the characteristic presentation. Whether onset in childhood predicts a more severe form of psoriasis is a matter of controversy, it may cause significant morbidity particularly if it keeps relapsing. Most children have mild form of psoriasis which can be generally treated effectively with topical agents such as emollients, coal tar, corticosteroids, dithranol, calcipotriol etc. according to age and the sites affected. Narrow band UVB is the preferred form of phototherapy in children for moderate to severe disease or in patients not responding to topical therapy alone. Systemic therapies are reserved for more severe and extensive cases that cannot be controlled with topical treatment and/or phototherapy such as severe plaque type, unstable forms like erythrodermic and generalized pustular psoriasis and psoriatic arthritis. There are no controlled trials of systemic therapies in this age group, most experience being with retinoids and methotrexate with favorable results. Cyclosporine can be used as a short-term intermittent crisis management drug. There is an early promising experience with the use of biologics (etanercept and infliximab) in childhood psoriasis. Systemic treatments as well as phototherapy have limited use in children due to cumulative dose effects of drugs, low acceptance, and risk of gonadal toxicity. More evidence-based data is needed about the effectiveness and long-term safety of topical, phototherapy and systemic therapies in children.

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Section: Phototherapymentioning

confidence: 98%

Childhood psoriasis

Dogra¹,

Kaur²

2010

Indian J Dermatol Venereol Leprol

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“…Pahlajani et al compared the efficacy and safety of a 308-nm excimer laser in children and adults [35]. Both the children (4 patients with a mean age of 11 years) and adults (12 patients with a mean age of 49 years) showed a significant decrease in PASI score.…”

Section: Childhood Psoriasismentioning

confidence: 97%

Evolution of targeted phototherapy for psoriasis

Kawada¹

2013

Expert Review of Dermatology

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Psoriasis is a major inflammatory disorder in the dermatological field. Phototherapy is effective and safe for psoriasis vulgaris. Narrow-band ultraviolet (UV) B and psoralen plus UVA are known to be the common modality as conventional non-targeted phototherapy. Non-targeted phototherapy making unnecessary irradiation to the unaffected skin may cause long-term adverse effects of UV. Targeted phototherapies with advantages, for example, higher dosages for lesional skin, a rapid clearing and longer remission rates, have been developed. Targeted phototherapies are preferably used for childhood, palmoplantar psoriasis, scalp and nail psoriasis as well as refractory lesions remained after whole-body UV therapy. Light sources of targeted phototherapy include broad-band UVB, narrow-band UVB, 308-nm excimer laser and light, 307-nm excimer light and 312-nm flat-type fluorescent lamp. This comprehensive review focuses recent evolution of target phototherapy for the treatment of psosriasis.KEYWORDS: 308-nm excimer laser/light • 312-nm flat-type fluorescent lamp • broad-band UVB • narrow-band UVB • psoriasis vulgaris • targeted phototherapy

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“…Some data on usage in childhood shows benefi t for children with localized psoriasis, and children may experience superior benefi t with excimer usage. Therapy has some ultraviolet light induced side effects, but is generally well tolerated [ 98 ].…”

Section: Phototherapymentioning

confidence: 99%

Pediatric Psoriasis

Pepper¹,

Pothiawala²,

Silverberg³

2014

Advances in Psoriasis

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Psoriasis is a chronic multi-system infl ammatory condition with an autoimmune component. One-third to one-half of cases have onset in childhood. There are a variety of pediatric variant types of psoriasis, including generalized disease, that is similar to adult psoriasis, and types distinctive to childhood, including diaper involvement and pityriasis amiantacea. Pediatric psoriasis is associated with infectious triggers and exacerbation by the Koebner phenomenon. Children with psoriasis may have more of a tendency toward obesity as refl ected by a large waist circumference. More extensive disease in childhood is associated with a poor quality of life. Therapeutics of pediatric psoriasis generally requires a global approach including identifying infectious triggers, addressing health risks including obesity, and psychological support. Prescription care includes application of mid-potency topical corticosteroids and/or calcipotriene, phototherapy with Narrowband UVB or excimer laser. In severe cases, cyclic prescribing of systemic agents for 6-12 months including methotrexate, cyclosporine and etanercept can aid in disease clearance with minimization of side effects.

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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

Cited by 42 publications

References 26 publications

Childhood psoriasis

Childhood psoriasis

Evolution of targeted phototherapy for psoriasis

Pediatric Psoriasis

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