Fikrle Tomás, Pizinger Karel
Hautklinik, Medizinische Fakultät der Karlsuniversität und Universitätskrankenhaus, Pilsen.
J Dtsch Dermatol Ges. 2003 Jul;1(7):559-63. doi: 10.1046/j.1610-0387.2003.03736.x.
Standard phototherapy for psoriasis (311 nm UVB or photochemotherapy) exposes the non-affected skin to potentially damaging irradiation. The use of 308 nm XeCl excimer laser allows the selective irradiation of psoriatic lesions. We evaluated its therapeutic effectiveness.
PATIENTS/METHODS: 28 patients with plaque stage psoriasis were involved in the study, 26 of them could be evaluated. In each patient a single plaque was chosen and then exposed to the laser irradiation thrice weekly. The initial dose was twice the MED (minimal erythema dose); the dosage was increased by one MED every second treatment. The usual dosages were 2-5 MED, while the cumulative UVB dosage was 3.6-15.2 J/cm2. 17 Patients were treated 6 times, while 11 were treated 10 times. The Psoriasis Severity Index (PSI) was calculated for the individual plaque in order to assess the effectiveness of the therapy. The patients were followed regularly for 3 months following treatment, and then checked again at 1 year.
Most patients showed clear improvement. In 90% the PSI at the end of treatment was reduced by at least 50%; in 72% it was only 33% of the pre-treatment value. The results between the patients receiving 6 and 10 treatments were similar. In 6 patients, the psoriatic lesion was still absent after 1 year, while in an additional 7, there had been long term improvement. The most common side effects were erythema and pruritus (100%), blisters (35%) and post-inflammatory hyperpigmentation (80%).
The use of the 308 nm excimer laser is effective for chronic localized psoriasis and may lead to long-lasting remissions.
银屑病的标准光疗（311nm 窄谱中波紫外线或光化学疗法）会使未受影响的皮肤暴露于可能具有损伤性的辐射中。使用 308nm 氙氯准分子激光可对银屑病皮损进行选择性照射。我们评估了其治疗效果。
患者/方法：28 例斑块状银屑病患者参与了本研究，其中 26 例可进行评估。在每位患者身上选择一个单一斑块，然后每周三次接受激光照射。初始剂量为最小红斑量（MED）的两倍；每隔一次治疗剂量增加一个 MED。常用剂量为 2 - 5 个 MED，而累积紫外线剂量为 3.6 - 15.2J/cm²。17 例患者接受 6 次治疗，11 例接受 10 次治疗。计算单个斑块的银屑病严重程度指数（PSI）以评估治疗效果。治疗后对患者进行了 3 个月的定期随访，然后在 1 年时再次检查。
大多数患者显示出明显改善。90%的患者治疗结束时 PSI 至少降低了 50%；72%的患者 PSI 仅为治疗前值的 33%。接受 6 次和 10 次治疗的患者结果相似。6 例患者在 1 年后银屑病皮损仍未出现，另外 7 例有长期改善。最常见的副作用是红斑和瘙痒（100%）、水疱（35%）和炎症后色素沉着（80%）。
使用 308nm 准分子激光对慢性局限性银屑病有效，且可能导致长期缓解。
