CO2 laser resurfacing of psoriatic plaques: a pilot study.
OBJECTIVE
Laser resurfacing can precisely remove epidermis and papillary dermis, sites pivotal to the pathogenesis of psoriasis. Our objective was to determine the efficacy and safety of superficially ablating carbon dioxide (CO2) lasers for treating isolated, recalcitrant psoriatic plaques.


METHODS
Twelve adult subjects with stable, plaque-type psoriasis were recruited. In six volunteers, the quadrants received different numbers of passes with a 60 microsec pulsed CO2 (Tru-Pulse) laser. In the remaining patients, one quadrant underwent curettage prior to resurfacing, the second resurfacing with a scanned continuous wave (Sharplan Silktouch) CO2 laser and the last curettage alone.


RESULTS
Despite clinical and histological evidence of complete ablation of the epidermis and papillary dermis, most quadrants recurred within 8 weeks. Surprisingly, two patients showed no recurrence after 4 months.


CONCLUSIONS
Ablation of the entire epidermis and papillary dermis with either pulsed or scanned CO2 lasers appears generally ineffective in treating recalcitrant psoriatic plaques, although the clearing seen in two patients suggests potentially successful future research directions.
Alora
M B
MB
Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston 02114, USA.
Anderson
R R
RR
Quinn
T R
TR
Taylor
C R
CR
D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002245:Carbon Dioxide / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003475:Curettage / Q000379:methods; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011565:Psoriasis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D002245:Carbon Dioxide