Ye Hui, Li Wei, Gan Yichuan, Zhu Enyi, Zheng Hongkai, Luo Quan, Zhang Sanquan, Zhang Xibao
Institute of Dermatology, Guangzhou Medical University, Guangzhou, 510095, People's Republic of China.
Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, 510095, People's Republic of China.
Clin Cosmet Investig Dermatol. 2024 Dec 18;17:2953-2959. doi: 10.2147/CCID.S493967. eCollection 2024.
Psoriasis is a chronic autoimmune skin disorder characterized by high morbidity and a tendency for recurrence. Although biologic therapy for lesion clearance can achieve PASI 90/100, refractory sites remain challenging to completely clear, particularly on the lower legs and elbows. To explore the efficacy of novel treatments for these resistant sites, we present a clinical observation on the safety and effectiveness of fractional carbon dioxide (CO2) laser therapy combined with secukinumab for four patients with moderate-to-severe plaque psoriasis. After receiving at least 3 months of maintenance treatment with secukinumab 300 mg, these patients received fractional CO laser therapy aimed at refractory sites on the lower legs. Treatments were administered every four weeks for a maximum course of 16 weeks. All four patients demonstrated improvement in the treatment of psoriasis lesions at refractory sites following the combined treatment approach. However, the degree of improvement differed among individuals. Leg Psoriasis Area and Severity Index (Leg-PASI) scores were reduced by 50% to 88%, while leg Physician's Global Assessment (PGA) scores showed a reduction of 50% to 75%. And no adverse effects were observed.
银屑病是一种慢性自身免疫性皮肤病，其特点是发病率高且有复发倾向。尽管用于清除皮损的生物疗法可实现银屑病面积和严重程度指数（PASI）改善90%/100%，但难治部位仍难以完全清除，尤其是小腿和肘部。为探索针对这些耐药部位的新治疗方法的疗效，我们对4例中度至重度斑块状银屑病患者进行了一项关于分次二氧化碳（CO2）激光治疗联合司库奇尤单抗的安全性和有效性的临床观察。在用300mg司库奇尤单抗进行至少3个月的维持治疗后，这些患者接受了针对小腿难治部位的分次CO2激光治疗。每四周进行一次治疗，最长疗程为16周。所有4例患者在采用联合治疗方法后，难治部位的银屑病皮损治疗均有改善。然而，个体间的改善程度有所不同。小腿银屑病面积和严重程度指数（Leg-PASI）评分降低了50%至88%，而小腿医生整体评估（PGA）评分降低了50%至75%。且未观察到不良反应。
