Phototherapy for Psoriasis: A Safe and Effective Treatment Modality

“Fewer people are doing mainstay full-body phototherapy as in the past, as biologics and other systemic therapies have proven to be safe and much more effective,” Dr. Nestor said in a recent interview with Dermatology Times.

“Additionally,” he added, “laser has largely taken over for individual and spot treatment of specific areas because you don’t have the same issue of systemic problems with burning.”

In the study, “Randomized, Investigator-Blinded Study to Compare the Efficacy and Tolerance of a 650-microsecond, 1064-nm YAG Laser to a 308-nm Excimer Laser for the Treatment of Mild to Moderate Psoriasis Vulgaris,” co-authored by Dr. Nestor, Daniel Fischer DO MS,^a and David Arnold DO^a eligible subjects enrolled in a randomized, investigator-blinded study.

Psoriatic plaques on one side of the body were treated with the 650-microsecond laser and plaques on the other side were treated with the 308-nm excimer laser. Study subjects received up to 15 treatments, twice weekly, or fewer if full clearance was achieved. Efficacy and tolerance were evaluated by the mPASI scores and local skin reactions, respectively.

Both devices showed efficacy in treating psoriatic plaques. Differences between the two devices were not significant for redness, thickness, scaliness, mPASI scores for arms and legs, and overall mPASI scores for the treated psoriatic plaques on each side of the body. The investigator-assessed scores for erosion/ulceration, vesicles, erythema, scaling, edema, and atrophy were low and identical for both sides of the body.

“There is potential for utilizing this therapy much more in the future, especially in areas such as the palms and soles, where excimer appears to be less effective,” Dr. Nestor said.