title: Concomitant treatment of psoriasis of the hands and feet with pulsed dye laser and topical calcipotriol, salicylic acid, or both: a prospective open study in 41 patients.
abstract: BACKGROUND
  Psoriasis of the hands and feet is a chronic disease which is often resistant to the usual topical therapies. It has considerable morbidity and seriously affects the quality of life of patients.
  
  
  OBJECTIVE
  We sought to prospectively evaluate the efficacy and safety of pulsed dye laser (PDL) treatment of psoriasis of the hands and feet.
  
  
  METHODS
  In all, 41 patients with therapy-resistant psoriasis of the hands and feet were treated once every 4 to 6 weeks with PDL at 585-nm wavelength, 450-microsecond pulse duration, 7-mm spot diameter, and 5- to 6.5-J/cm2 fluence. Calcipotriol ointment and salicylic acid 5% to 10% ointment were used as keratolytic agents. Treatment efficacy was evaluated by blinded comparison of photographs of the lesions taken before and after PDL treatment in each patient.
  
  
  RESULTS
  A good to very good improvement in the lesions was observed in 76% of the patients after treatment. An average duration of remission was 11 months. Side effects were transient purpura, moderate discomfort during the treatment, transient hyperpigmentation or hypopigmentation, and incidental transient crustae.
  
  
  CONCLUSIONS
  This was an open prospective study with a limited number of patients who were concomitantly treated with calcipotriol and salicylic acid ointment. Patients with photointolerance, on medication with phototoxic or photoallergic drugs, and with widespread psoriasis were excluded.
  
  
  CONCLUSIONS
  Concomitant treatment with PDL and topical calcipotriol, salicylic acid, or both was a satisfactory modality for treating psoriasis of the hands and feet. There was a subjective improvement in the symptoms and quality of life in all patients.
authors.affiliation: Department of Dermatology and Venereology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. j.deleeuw@erasmusmc.nl
authors.forename: Jaap
authors.initials: J
authors.lastname: de Leeuw
authors.forename: Bhupendra
authors.initials: B
authors.lastname: Tank
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bjerring
authors.forename: Suzanne
authors.initials: S
authors.lastname: Koetsveld
authors.forename: Martino
authors.initials: M
authors.lastname: Neumann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies; D011565:Psoriasis / Q000188:drug therapy / Q000628:therapy*; D012074:Remission Induction; D020156:Salicylic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D007641:Keratolytic Agents; D009824:Ointments; C055085:calcipotriene; D002117:Calcitriol; D020156:Salicylic Acid