CO2-LASER RESURFACING OF PSORIATIC PLAQUES - A PILOT-STUDY

Background and Objective: Laser resurfacing can precisely remove epide rmis and papillary dermis, sites pivotal to the pathogenesis of psoria sis. Our objective was to determine the efficacy and safety of superfi cially ablating carbon dioxide (CO2) lasers for treating isolated, rec alcitrant psoriatic plaques. Materials and Methods: Twelve adult subje cts with stable, plaque-type psoriasis were recruited. In six voluntee rs, the quadrants received different numbers of passes with a 60 mu se c pulsed CO2 (Tru-Pulse) laser. In the remaining patients, one quadran t underwent curettage prior to resurfacing, the second resurfacing wit h a scanned continuous wave (Sharplan Silk-touch) CO2 laser and the la st curettage alone. Results: Despite clinical and histological evidenc e of complete ablation of the epidermis and papillary dermis, most qua drants recurred within 8 weeks. Surprisingly, two patients showed no r ecurrence after 4 months. Conclusion: Ablation of the entire epidermis and papillary dermis with either pulsed or scanned CO2 lasers appears generally ineffective in treating recalcitrant psoriatic plaques, alt hough the clearing seen in two patients suggests potentially successfu l future research directions. (C) 1998 Wiley-Liss, Inc.