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Derm News: 2007.28(10)

Pulsed dye laser versus treatment with calcipotriol/betamethasone dipropionate for localized refractory plaque psoriasis: Effects on T-cell infiltration, epidermal proliferation and keratinisation

Journal of Dermatological Treatment, 18(1):32-39
Jorn H. Bovenschen; Angelina Erceg; Ivonne Van Vlijmen-Willems; Peter C. M. Van De Kerkhof; Marieke M. B. Seyger
ABSTRACT

Background

Selective photothermolysis of diseased capillaries by pulsed dye laser (PDL) treatment has been described as a mechanism for long-lasting clearance of psoriatic plaques.

Objectives

To evaluate PDL and a two-compound formulation of calcipotriol/betamethasone dipropionate ointment for the treatment of localized, recalcitrant plaque psoriasis.

Methods

Eight psoriatic patients were treated for 4 weeks with both PDL and topical calcipotriol/betamethasone dipropionate in an open, intra-patient, left-right comparison. Biopsies were analyzed for T-cell subsets, cells expressing NK-receptors, epidermal proliferation, differentiation and epidermal thickness.

Results

After active treatment, both treatments showed statistically significant but comparable improvements of T-cell subsets, epidermal proliferation, differentiation and epidermal thickness. In line with the clinical results, after an 8-week follow-up period statistically significant further reductions were observed for dermal CD3+, CD4+, CD45RO+, CD2+ T cells, epidermal CD3+, CD8+, CD45RO+, CD2+, CD25+ T cells and the epidermal parameters for the PDL-treated plaques, in contrast to the topically treated plaques.

Conclusions

After 8 weeks of follow-up, PDL treatment for localized and recalcitrant plaque psoriasis resulted in persistent reductions of activated and memory effector T-helper cells in the dermis, cytotoxic T cells in the epidermis, and normalization of epidermal proliferation and keratinization, in contrast to treatment with calcipotriol/betamethasone dipropionate ointment.


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The Derm News service provided by the Editorial Consultants of Skin Therapy Letter© and its founding editor Dr. Stuart Maddin.