Targeted UVB-308 nm (NUVB) therapy with excimer laser in the treatment of atopic dermatitis and other inflammatory dermatoses

Abstract

UVB 311 nm phototherapy (NUVB) is used successfully in the treatment of psoriasis or atopic dermatitis and is often chosen as "first-line" therapy. In a prospective study we investigated the efficacy of the targeted UVB 308 phototherapy by excimer laser in the treatment of 57 patients with localized, mild therapy-resistant atopic dermatitis. We achieved a complete remission (CR) in nearly 85% and a partial remission (PR) in 15% after 10 treatments during 6-8 weeks in all patients. A mean reduction in patient-reported pruritus was one hallmark after 3-4 treatments. 48 other patients with lichen simplex chronicus Vidal, nodular prurigo, granuloma anulare, alopezia areata (AA) and lichen ruber planus were also treated by targeted NUVB. We found higher rates of CR and PR only in patients with AA and in patients with oral Lichen ruber mucosae. These results and the systematically reviewing of the current medical literature shows that targeted NUVB by excimer laser cannot be successfully transferred for all inflammatory skin diseases. In particular, Excimer UVB treatment expands the therapeutic options in patients with localized and therapy-resistant atopic dermatitis enormously.

Consensus‐based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I

“…Other devices such as 308-nm monochromatic excimer laser expand the therapeutic options in patients with localized and therapyresistant AE even though they can treat only limited surfaces. 182,183 Pulsed-dye laser for the treatment of chronic AE is still experimental. 184 Currently, the mainstay for phototherapy in Europe is NB-UVB and UVA1.…”

S1‐Leitlinie zur UV‐Phototherapie und Photochemotherapie

“…Excimer‐Licht). Dieses konnte, neben der gezielten Behandlung von einzelnen Psoriasisplaques und etwas geringerer Wirkung bei der palmoplantaren pustulösen Psoriasis , auch bei der atopischen Dermatitis und der Vitiligo erfolgreich eingesetzt werden. Ebenso ist die Excimer‐Therapie bei der Alopecia areata des Erwachsenen und unter strenger Indikationsstellung bei Jugendlichen wirksam einsetzbar.…”

UVB 308‐nm excimer light and bath PUVA: combination therapy is very effective in the treatment of prurigo nodularis

“…In open prospective studies, several authors demonstrated a complete response or a significant improvement in most patients after 4–6 weeks of treatment with a cumulative dose >20 J/cm 2 UVA 16,20 . The targeted UVB excimer laser therapy is able to penetrate the parakeratotic hyperkeratosis because of the exact MEDI doses, which is 4–5 times that of the MED 8 …”