Use of 308 nm excimer laser for the treatment of chronic hand and foot eczema

• Published in: International journal of dermatology 2016-08, Vol.55 (8), p.e447-e453
• Main Authors: Shroff, Anjali, Malajian, Dana, Czarnowicki, Tali, Rose, Sharon, Bernstein, Daniel M., Singer, Giselle K., Lebwohl, Mark G., Hadi, Suhail, Guttman-Yassky, Emma
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Child; Chronic Disease; Cohort Studies; Eczema - diagnosis; Eczema - radiotherapy; Female; Follow-Up Studies; Foot Dermatoses - diagnosis; Foot Dermatoses - radiotherapy; Hand Dermatoses - diagnosis; Hand Dermatoses - radiotherapy; Humans; Lasers, Excimer; Low-Level Light Therapy - methods; Male; Middle Aged; Patient Satisfaction - statistics & numerical data; Retrospective Studies; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome; Young Adult
• ISSN: 0011-9059; 1365-4632
• DOI: 10.1111/ijd.13205

Background Chronic hand and foot eczema (CHFE), a prevalent debilitating disorder affecting approximately 15% of the population, presents a socioeconomic and psychosocial burden for patients and often follows a chronic course, refractory to conventional therapies. Thus, a large need exists for more effective therapeutics; the excimer laser (308 nm) is effective for some inflammatory skin diseases, but its efficacy has not been evaluated for CHFE. Methods The study is a retrospective chart review conducted on 30 patients with recalcitrant CHFE (19 with hand involvement, four with foot involvement, and seven with both) treated twice weekly with excimer laser (308 nm) single wavelength ultraviolet (UV)B radiation between January 2013 and December 2014. Results Improvements in clinical scores included a 69% reduction in average physician's global assessment (PGA) scores (from 2.77 at baseline to 0.87 after treatment, P < 0.0001) with a parallel reduction in average modified total lesion/symptom scores of 70% (from 10.2 to 3.1, P < 0.0001). Only mild sunburn‐like reactions were observed. Conclusion This report evaluates excimer laser for patients with refractory CHFE and shows excellent and sustained efficacy for this treatment. Compared to other UV therapies, excimer laser offers lower cumulative doses of UV radiation by targeting specific areas. This effective treatment should be considered alone or in combination with other established or newer therapies.