Clinical and histologic evaluation of psoriatic plaques treated with a flashlamp pulsed dye laser

Background: Psoriatic plaques can be cleared by destruction of the dermal papillae. Dilated vessels, the major component of psoriatic dermal papillae, can be selectively destroyed with yellow light lasers. Previous investigators have demonstrated partial clearing of psoriatic plaques after treatment...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 1996-07, Vol.35 (1), p.64-68
Main Authors: Zelickson, Brian D., Mehregan, David A., Wendelschfer-Crabb, Gwen, Ruppman, Dan, Cook, Anne, O'Connell, Polly, Kennedy, William R.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Biopsy
Blood Vessels - pathology
Dilatation, Pathologic - pathology
Dilatation, Pathologic - therapy
Diseases of the skin. Cosmetics
Female
Follow-Up Studies
Humans
Laser Therapy
Male
Medical sciences
Microscopy, Confocal
Middle Aged
Phototherapy - methods
Psoriasis - pathology
Psoriasis - therapy
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Remission Induction
Skin - blood supply
Skin - pathology
Treatment Outcome
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Summary:Background: Psoriatic plaques can be cleared by destruction of the dermal papillae. Dilated vessels, the major component of psoriatic dermal papillae, can be selectively destroyed with yellow light lasers. Previous investigators have demonstrated partial clearing of psoriatic plaques after treatment with a pulsed dye laser (PDL) (585 nm). Objective: This study was designed to examine the clinical and histologic events of psoriasis treated with the PDL. Methods: Psoriatic plaques were treated with a short (450 μsec) and long (1500 μsec) pulsewidth PDL. Photographs of the plaques were used for clinical assessment. Biopsy specimens were examined microscopically. Results: Significant clinical improvement was seen, and no significant difference between the long and short pulsewidth lasers was found. Patients responding to treatment with the PDL remained in remission for up to 13 months. Histologic normalization occurred after treatment. Two pretreatment vascular patterns were seen: vertically oriented vessels with few horizontal vessels and numerous tortuous vessels. Tortuous vessels were associated with poor clinical results. Conclusion: The PDL can induce prolonged remission in chronic plaque psoriasis. The vascular pattern may help to distinguish those patients likely to respond to this treatment.
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(96)90498-3