308-nm Excimer Laser for the Treatment of Alopecia Areata

BACKGROUND Alopecia areata is loss of hair from localized or diffuse areas of hair-bearing area of the skin. Recently there are reports of efficacy of the 308-nm excimer radiation for this condition.
OBJECTIVE To study the effect of the 308-nm excimer laser in the treatment of alopecia areata.
MATERIALS AND METHODS Eighteen patients with 42 recalcitrant patches (including 1 adult with alopecia totalis) were enrolled in this study. The lesions were treated with the 308-nm excimer laser twice a week for a period of 12 weeks; one lesion on each patient was left as a control for comparison.
RESULTS There were 7 males and 11 females in this study. Regrowth of hair was observed in 17 (41.5%) patches. Thirteen of the 18 lesions in scalp showed a complete regrowth of hair. The extremity regions failed to show a response. Atopic diatheses had an unfavorable effect on the outcome in our patients.
CONCLUSION The 308-nm excimer laser is an effective therapeutic option for patchy alopecia areata of the scalp and for some cases with patchy alopecia areata of the beard area. It does not work for patchy alopecia areata of the extremities.     

The Use of the 308-nm Excimer Laser for the Treatment of Vitiligo

BACKGROUND: Recent reports show that 308-nm excimer laser may be an effective and safe method for the treatment of vitiligo, which is usually resistant to other available treatment methods. OBJECTIVE: The objective was to study the effectiveness of the new 308-nm excimer laser for the treatment of vitiligo. METHODS: A retrospective chart review of thirty-two patients with 55 spots of vitiligo were enrolled; a population-based sample was studied that included men and women, adults and children, with different ethnic backgrounds. The treatment was started with the lowest dose, which is 100 mJ/cm(2) (comparable to one minimal erythema dose value and one multiplier). Depending on Fitzpatrick skin type, the dose was raised gradually in a stepwise fashion. In skin types I to II, the same does was repeated twice before going up to avoid burns. Patients were treated for 30 sessions, or 75% repigmentation, whichever comes first. RESULTS: Overall 55 spots were treated: 29 (52.8%) had 75% pigmentation or greater, and 35 (63.7%) had 50% pigmentation or greater. The best results were on the face: of the 21 spots treated 15 (71.5%) had 75% pigmentation, and 16 (76.2%) had 50% pigmentation or greater. Other areas (neck, extremities, trunk, and genitals) had moderate response in comparison to the face. The least response was on the hands and feet; of the 5 spots treated only 20% showed 50% pigmentation or more. CONCLUSION: Slightly more than 50% of the patients tested showed 75% or more pigmentation of their lesions, after 30 treatments or less; most of the responders had Fitzpatrick skin type III and above. All the untreated patches (controls) remained unchanged. This demonstrates that the 308-nm excimer laser is an effective method of treatment for vitiligo.     

Treatment of Striae Rubra and Striae Alba With the 585-nm Pulsed-Dye Laser

BACKGROUND: The treatment of striae distensae has recently been reported with various lasers such as the 585-nm pulsed dye laser. At lower fluences (2.0 to 4.0 J/cm2), this laser has been purported to increase the amount of collagen in the extracellular matrix. OBJECTIVE: To determine whether the 585-nm pulsed dye laser is effective in both striae rubra and striae alba after two treatments and, in addition, to determine whether there is a net effect on collagen density in treated samples. METHODS: Twenty patients (skin types II to VI) with either striae rubra (9) or striae alba (11) were treated at baseline and at week 6. The total length of the study was 12 weeks. Untreated striae on the same patient were used as control subjects. Striae clinical parameters such as color and area were measured before the first and after the last treatment by an independent examiner using a visual analog scale. A hydroxyproline assay was used to measure collagen changes in two of the striae quantitatively. RESULTS: The 585 nm had a moderate beneficial effect in reducing the degree of erythema in striae rubra. There was no apparent clinical change on striae alba. Total collagen per gram of dry weight of sampled tissue increased in striae treated with pulsed dye laser versus control subjects. CONCLUSION: We recommend the use of the 585-nm pulsed dye laser for striae rubra in patients skin types II to IV. Extreme caution or avoidance should be observed in pulsed dye laser treatments for patients with phototypes V to VI even with the use of low fluences. Tissue collagen changes measured may be an early change, which precedes significant clinical improvement.     

Treatment of Inverse Psoriasis with the 308 nm Excimer Laser

BACKGROUND: The treatment of inverse psoriasis can be both challenging and frustrating. Conventional topical and systemic treatments can be limited in terms of efficacy, acceptability and safety. The 308 nm excimer laser has been shown to be effective in the treatment of psoriatic plaques. METHODS: A patient with chronic inverse psoriasis was treated with 308 nm excimer laser using a 3.5 cm spot, a dosage of 2 minimal erythema doses and a pulse width of 30 ns. RESULTS: Complete clearance of the psoriatic lesions was obtained after 3 weeks of treatment. Remission duration was at least 6 months. CONCLUSION: The 308 nm excimer laser is safe and effective for the treatment of inverse psoriasis. Treatments are well tolerated with minimal side effects.     

308准分子光联合点阵CO2激光对难治性白癜风的治疗效果

目的 探析308 nm准分子光联合点阵CO2激光在难治性白癜风中的效果。方法 选取我院2022年 4月-2023年9月收治的难治性白癜风患者78例,采用随机抽样法分为参照组和结合组,各39例。参照组应 用308 nm准分子光治疗,结合组应用308 nm准分子光联合点阵CO2激光治疗。比较两组白斑面积、血清抗 酪氨酸酶抗体水平、氧化应激指标、临床疗效及不良反应发生率。结果 结合组治疗后白斑面积小于参照 组（P ＜0.05）;结合组治疗后血清抗酪氨酸酶抗体、丙二醇水平低于参照组,超氧化物歧化酶水平高于 参照组（P＜0.05）;结合组治疗总有效率为97.44%,高于参照组的82.05%（P＜0.05）;结合组不良反应发 生率为5.13%,低于参照组的15.38%,但差异无统计学意义（P ＞0.05）。结论 308 nm准分子光联合点阵 CO2激光可缩小难治性白癜风患者白斑面积,降低其血清抗酪氨酸酶抗体水平,改善氧化应激指标,且治 疗安全性较高。     

Radiofrequency and 585-nm Pulsed Dye Laser Treatment of Striae Distensae: A Report of 37 Asian Patients

BACKGROUND: Various lasers have recently been reported as effective treatment modalities for striae distensae, but pigmentary alterations are a major concern to the darker skin type. The Thermage (Therma Cool TC; Thermage Inc, Hayward, CA) is a radiofrequency device for the lifting of face and neck, and there is no report of using it for striae distensae. OBJECTIVE: The purpose was to evaluate the effectiveness of the Thermage in combination with pulsed dye laser. MATERIALS AND METHODS: Thirty-seven patients with abdominal striae distensae were treated with the Thermage and 585-nm pulsed dye laser in the first session at baseline. An additional two sessions of pulsed dye laser were performed at Weeks 4 and 8. Thermage was used at fluences of 53 to 97 J/cm2 and pulsed dye laser at fluences of 3.0 J/cm2 with 10-mm spot. Skin biopsies were taken of nine patients. RESULTS: In the subjective assessment, 89.2% of the patients showed "good and very good" to overall improvement, and 59.4% were graded as "good and very good" in elasticity. All of the nine specimens showed an increase in the amount of collagen fibers, and increased elastic fibers were found in six specimens. CONCLUSION: The Thermage and pulsed dye laser appear to be an effective treatment for striae distansae.     

中医温通方法结合308 nm准分子激光治疗斑秃的效果

目的 探究中医温通方法结合308 nm准分子激光治疗斑秃的效果。方法 收集2023年1月-2024年1月 齐齐哈尔市第一医院收治的斑秃患者69例,按照治疗方法不同分为火针联合3 0 8 nm准分子激光组 （A组）、火针组（B组）、308 nm准分子激光组（C组）,各23例,比较三组临床疗效、终毛密度、 脱发症状改善评分、皮肤病生活质量指数评分及不良反应发生率。结果 A组临床总有效率高于B组、 C组（P ＜0.05）;A组治疗后终毛密度高于B组、C组（P＜0.05）;A组脱发症状改善评分高于B组、C组,皮 肤病生活质量指数评分低于B组、C组（P＜0.05）;三组不良反应发生率比较,差异无统计学意义（P＞0.05）。 结论 中医温通治疗联合308 nm准分子激光治疗斑秃的疗效良好,可增加终毛密度,改善脱发症状,提升 患者生活质量,且具有较高的安全性。     

308 nm Excimer laser ablation of cartilage

This article reports the investigation of the XeCl excimer laser as a cutting-ablating tool for human fibrocartilage and hyaline cartilage. Quantitative measurements were made of tissue ablation rates as a function of fluence in meniscal fibrocartilage and articular hyaline cartilage. A force of 1.47 Newtons was applied to an 800-μm fiber with the laser delivering a range of fluences (40-190 mJ/mm²) firing at a frequency of 5 Hz. To assess the effect of repetition rate on depth per pulse, a set of measurements was made at a constant fluence of 60 mJ/mm², with the repetition rate varying from 10 to 40 Hz. Histologic and morphometric analysis of preserved specimens was performed using light microscopy. The results of these studies revealed that the ablation rate was directly proportional to fluence over the range tested. Fibrocartilage was ablated at a rate 2.56 times faster than hyaline cartilage. Repetition rate had no effect on the penetration per pulse. Adjacent tissue damage was noted to be minimal (10–70 μm). The excimer laser achieved ablation rates adequate for arthroscopic applications. © 1994 Wiley-Liss, Inc.     

Excimer ablation of human intervertebral disc at 308 nanometers

Excimer laser energy, which has been shown to photoablate tissue at a precisely controllable rate with minimal thermal damage, was applied to human intervertebral disc in an effort to develop a technique for percutaneous discectomy. Cadaveric samples of human disc were used. Excimer laser energy was produced by a XeCl, magnetically switched, long-pulse laser working at 308 nm, 20 Hz. Annulus tissue of approximately 1 mm thickness was placed in contact with the output tip of a 400 microns core diameter quartz fiber, and measurements of ablation rate were made at different radiant exposures. Ablation rates were found to vary linearly with radiant exposure, from 0.7 micron/pulse at 10 mJ/mm2 to 11.0 microns/pulse at 55 mJ/mm2, with a correlation coefficient of 0.984. Threshold radiant exposure, calculated by extrapolation, was found to be about 7 mJ/mm2. Histologic analysis showed a minimum of thermal damage in these specimens, and when ablated with modification to maintain constant fiber-tissue contact, thermal injury was nearly absent, as compared to samples ablated with Nd:YAG through a contact probe. Thermographic analysis, performed using the AGA 782 Digital Thermography system, showed increasing temperature with increasing radiant exposure, with a maximum temperature of 47.2 degrees C at 55 mJ/mm2. In that precise tissue ablation was demonstrated with minimal generated heat, and excimer energy at 308 nm is transmissible through fiber optics, excimer holds great promise for the development of a percutaneous discectomy technique.     

308 nm准分子紫外光治疗斑秃的效果

目的 探究对斑秃患者采用308 nm准分子紫外光治疗的临床效果。方法 选择我院2018年10月-2023年 10月收治的80例斑秃患者为研究对象,按随机数字表法分为对照组和观察组,每组40例。对照组给予 常规药物治疗,观察组在对照组的基础上给予308 nm准分子紫外光治疗,比较两组临床疗效、并发症 发生情况、治疗满意度、斑秃面积及毛发密度。结果 观察组治疗总有效率为97.50%,高于对照组的 80.00%,差异有统计学意义（P ＜0.05）;观察组并发症发生率为0,低于对照组的12.50%,差异有统 计学意义（P＜0.05）;观察组治疗满意度为95.00%,高于对照组的80.00%,差异有统计学意义（P＜0.05）; 观察组斑秃面积小于对照组,毛发密度大于对照组,差异有统计学意义（P＜0.05）。结论 308 nm准分子 紫外光治疗斑秃的效果良好,可有效改善患者的斑秃症状,缩小斑秃面积,改善毛发密度,且治疗后并发 症发生几率较低,安全性较高,有利于提高患者满意度。     

Follow-up survey of 308-nm laser treatment of psoriasis

BACKGROUND AND OBJECTIVES: UVB treatment with a 308-nm excimer laser is a new treatment modality for localized psoriasis. The purpose of this study is to assess patients' impressions and satisfaction with 308-nm laser treatment of mild to moderate psoriasis. STUDY DESIGN/MATERIALS AND METHODS: Telephone survey data were obtained from patients after participation in a case series study of 124 patients with mild to moderate psoriasis treated with 308-nm UVB laser treatment for a target plaque and other lesions. The survey included information on changes in the target plaque, remission time, changes in other areas of psoriasis, satisfaction with the result, side effects of treatment, and efficacy relative to other treatments. RESULTS: Patients (55% of total) reported overall satisfaction with the treatments, and 63% of patients thought they needed additional laser treatments, including for maintenance. Subjects (25%) reported that the laser treatments were better than any other treatment they had tried. Adverse effects were mild and had either disappeared or were significantly decreased in 86% of patients. Self reported length of remission compared favorably to those for other therapies for localized disease. CONCLUSIONS: UVB laser treatments provide a well-tolerated means to clear psoriasis plaques. The treatment provides a high level of patient satisfaction.     

Millisecond 1064-nm Neodymium:YAG Laser Treatment of Facial Telangiectases

BACKGROUND: Millisecond pulse duration 1064-nm Neodymium:YAG (Nd:YAG) lasers have been shown to be effective in the treatment of some lower leg telangiectases. OBJECTIVE: To evaluate the efficacy and complication rate of a millisecond pulse duration 1064-nm Nd:YAG laser in the treatment of facial telangiectases. METHODS: Fifteen subjects were evaluated. RESULTS: Moderate to significant improvement was seen in 73% patients at day 30 and in 80% of patients at 3 months. These results were seen in the treatment of both blue/red and red facial telangiectases. CONCLUSION: The millisecond pulse duration 1064-nm Nd:YAG laser is effective for treatment of facial telangiectases.     

532-nm Diode Laser Treatment of Seborrheic Keratoses with Color Enhancement

BACKGROUND Seborrheic keratoses (SKs) are benign cutaneous tumors of the epidermis. Localization in the head and neck areas can produce an unsightly appearance. Recurrence after curettage, shave excision, cryoablation, or chemical peel can be common.
OBJECTIVE The objective was to determine if laser ablation with the 532-nm laser and color enhancement is effective in removing SKs.
MATERIALS AND METHODS A total of 326 patients who presented with 1,567 benign SKs were treated with the DioLite (Iridex Corp.) and VersaPulse cosmetic (Coherent Inc.) 532-nm diode lasers with color enhancement using a red marker or ferric subsulfate. The DioLite was set at 27 to 30 J with a 2- to 3-mm spot size, and a 10-ms pulse width was used for ablation. The VersaPulse was set at a lower energy of 9.5 to 12 J/cm² with a 3-mm spot size, 3- to 6-Hz repetition rate, and 10-ms pulse duration for ablation. All patients were Caucasian.
RESULTS Complete resolution of the SKs occurred in 93% of lesions. Seven percent of SKs required a second round of laser treatment for incomplete ablation. There were no cases of hyperpigmentation or hypertrophic scar formation of the skin following laser treatment. Hypopigmentation occurred in 6% of patients and was associated with old, chronic, or recalcitrant lesions.     

Treatment of vitiligo by 308-nm excimer laser: an evaluation of variables affecting treatment response

BACKGROUND AND OBJECTIVES: To determine the true efficacy of the 308-nm excimer laser for the treatment of vitiligo, while taking into account confounding factors such as anatomic site of treatment, age, sex, skin type, MED, and duration of evolution of the vitiligo. STUDY DESIGN/MATERIALS AND METHODS: Thirty-five patients with vitiligo were included. Each lesion was treated twice a week by the 308-nm excimer laser for a maximum of 24 sessions. Efficacy was blindly evaluated by two independent physicians. RESULTS: Repigmentation was noted in 46 plaques/52 (88.5%). Repigmentation rate (75%) was obtained in 14 (26.9%). In "UV sensitive" areas (face, neck, trunk), 8/14 lesions (57.1%) had a repigmentation rate, 75% versus 6/38 (15.8%) in "UV resistant" areas (bony prominences and extremities) (P = 0.031). No relationship could be established between response to the treatment and the following variables: age, sex, skin type, MED, and duration of evolution of the vitiligo (respectively, P = 1, 0.666, 0.566, 0.628, 0.521). CONCLUSIONS: An aesthetically reasonable result is achieved essentially in "UV sensitive" areas, thus appearing to be the appropriate places of choice for this treatment.     

Treatment of oral lichen planus with the 308-nm UVB excimer laser--early preliminary results in eight patients

BACKGROUND AND OBJECTIVES: Oral lichen planus (OLP) is a chronic disease of uncertain origin. Many patients with OLP are refractory to all available therapies. The 308-nm excimer laser was used as a possible additional method in the treatment of OLP. STUDY DESIGN/MATERIALS AND METHODS: Eight patients with OLP were treated using the 308-nm UVB excimer laser. RESULTS: Clinical improvement was achieved in six patients. Two patients showed complete remission, of which one patient showed recurrence of the lesions after 4 weeks. CONCLUSION: The preliminary results in our opinion warrant further studies of this treatment.     

Granuloma Annulare Treated with Excimer Laser

Objective: To review the current therapy for granuloma annulare and report a case of refractory generalized granuloma annulare successfully treated with excimer laser. A discussion about the characteristics of excimer laser and the mechanism of its effectiveness is presented. Design: Patient case report and literature review. Setting: Outpatient dermatology practice. Participants: A 73-year-old woman suffering from generalized granuloma annulare for more than 40 years. Measurements: Change in clinical appearance of lesions. Results: Use of excimer laser therapy resulted in prompt and complete resolution in treated areas with no residual skin changes or side effects. Conclusion: Excimer laser therapy is a powerful treatment modality with minimal side effects for patients with granuloma annulare. Further study is necessary to elucidate optimal dosing, long-term efficacy, and safety profile.Granuloma annulare (GA) is a relatively common disorder with a female predominance that usually presents as 1 to 5cm skin-colored or erythematous annular plaques with peripheral papules. While the localized form most frequently affects the dorsal surfaces of the extremities, GA may also have a generalized distribution characterized by more than 10 sites of involvement, frequently including the trunk, neck, scalp, and occasionally face.The localized form has the highest incidence in patients under 30 years old and tends to have spontaneous resolution, with approximately one-half of lesions resolving within two years after diagnosis.1,2 Generalized GA has a bimodal distribution, with a peak in children less than 10 years of age and adults older than 40 years of age. Generalized GA exhibits more tenacious behavior and can occasionally be present for more than 10 years without resolution.2 These lesions are typically asymptomatic and patients most commonly seek treatment for cosmetic reasons.3Histologically, GA is characterized by palisading histiocytes and lymphocytes surrounding an amorphous center of degenerating collagen and prominent mucin. This idiopathic reaction is believed to be a type IV hypersensitivity response to an unidentified antigen.2,6,7Treatment of GA is dictated by lesion distribution. Localized GA has been successfully treated with topical therapy, including steroids under occlusion, intralesional steroid injections, and cryotherapy. Reports of successful treatment with topical tacrolimus as well as a combination of rifampin, ofloxacin, and minocycline have also been observed.4,5Generalized GA requires aggressive systemic treatment to achieve clinical results. Psoralen + ultraviolet A therapy (PUVA), isotretinoin, dapsone, and cyclosporine have shown effectiveness in resolving generalized GA; however, these therapies are associated with serious side effects, which limit their utility.6Several case reports and small trials have shown PUVA therapy to have an efficacy rate of 80 to 100 percent in clearing or significantly reducing GA lesions. Treatment duration is dependent on extent of disease and response to treatment.7,8 While effective at clearing GA, PUVA requires both frequent treatments and psoralen ingestion, which can cause gastrointestinal side effects and photosensitization with erythema and pruritus at treatment sites. Long-term use leads to actinic damage localized to treatment areas and an increased risk of cutaneous malignancy.9Isotretinoin has been used in diffuse GA in patients intolerant or unresponsive to PUVA. Case reports have shown inconsistent efficacy, with either primary treatment failure or recurrence of lesions after discontinuation of therapy; the majority of cases, however, respond to the drug.6 Although effective, isotretinoin therapy is difficult to initiate and maintain. The prescribing physician, patient, and patient’s pharmacist are required to enter the iPledge registry and the patient is subject to mandatory initiation of two methods of birth control with monthly pregnancy tests and office evaluations to prevent isotretinoin’s teratogenicity. These requirements as well as the potential systemic side effects, including hyperlipidemia, hyperglycemia, hepatitis, hematologic dyscrasias, and mental status changes, decrease patient compliance with therapy.Several reports demonstrated that dapsone had clinical merit in resolving generalized GA, but treatment failures resulted from drug ineffectiveness and intolerable side effects ranging from headaches, nausea, and hepatitis to agranulocytosis and aplastic anemia.10,11 Physicians treating with dapsone must be aware of its oxidative potential with resultant hemolytic anemia, and patients should be screened with a glucose-6-phosphate dehydrogenase assay prior to therapy. After treatment is initiated, complete blood counts (CBCs) are drawn weekly for the first month of therapy and then monthly for six months. Baseline liver function should be evaluated and values rechecked every three months of therapy.12 Published reports suggest that successful therapy is clinically evident by 12 weeks of therapy, exposing patients to extensive blood work and monitoring, which adds to treatment inconvenience.Recently, Inui et al13 reported a patient with GA unresponsive to topical steroids and tacrolimus treated with narrowband ultraviolet B (NBUVB) resulting in resolution in 24 treatments with absence of recurrence. Another retrospective study of NBUVB noted “minimal to mild” improvement of generalized GA, but did not mention treatment regimen, duration, or patient compliance and satisfaction.14