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A Gain-switched 311-nm Titanium:Sapphire Laser Treatment in Palmoplantar Pustulosis

대한피부과학회지 2020년 58권 9호 p.601 ~ 607
오용우, 김동희, 서병학, 서호석, 최유성,
소속 상세정보
오용우 ( Oh Yong-Woo ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Dermatology
김동희 ( Kim Dong-Hee ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Dermatology
서병학 ( Seo Byeong-Hak ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Dermatology
서호석 ( Suh Ho-Seok ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Dermatology
최유성 ( Choi Yu-Sung ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Dermatology

Abstract


Background: Palmoplantar pustulosis is a specific form of localized pustular psoriasis occurring on the palm and sole. Multiple therapeutic options, including topical and systemic agents as well as phototherapies, are available for palmoplantar pustulosis; however, treatment outcomes are not satisfactory in most cases. Recently, a gain-switched 311-nm Ti:Sapphire Laser was developed and showed good treatment response in vitiligo and atopic dermatitis.

Objective: To investigate the efficacy and safety of the 311-nm Ti:Sapphire Laser in the treatment of palmoplantar pustulosis.

Methods: A total of 24 patients with palmoplantar pustulosis were treated with a 311-nm Ti:Sapphire Laser twice a week for up to 32 sessions and had a 3-month follow-up visit. The treatment dose started at 300 mJ/cm2 and was increased by 50 mJ/cm2 at each subsequent session. The Palmoplantar Pustular Psoriasis Area and Severity Index score, 5-grade patient satisfaction score, and adverse events were evaluated.
Results: The mean Palmoplantar Pustular Psoriasis Area and Severity Index score decreased from 8.31±3.31 at baseline to 4.75±2.70 at 16 sessions, 3.26±2.18 at 32 sessions, and 4.05±2.19 at follow-up visit. In the subgroup analysis, non-smokers and emollients user groups showed better responses in Palmoplantar Pustular Psoriasis Area and Severity Index (p=0.033 and p=0.027, respectively). Adverse effects, including burning sensation and transient erythema, were limited and well-tolerated.

Conclusion: The 311-nm Ti:Sapphire Laser can be considered as a treatment option for palmoplantar pustulosis.
Moreover, habitual risk factor modifications, such as smoking cessation and steady use of emollients, can impact treatment outcomes in patients with palmoplantar pustulosis.

키워드

311-nm Ti:Sapphire laser; Palmoplantar pustulosis; Phototherapy

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