title: Efficacy of the pulsed dye laser in the treatment of localized recalcitrant plaque psoriasis: a comparative study.
abstract: BACKGROUND
  Localized chronic plaque psoriasis, resistant to local therapy, may be very hard to treat. The treatment of these lesions with a pulsed dye laser (PDL) has been described before, but a comparative study between the PDL and a potent topical treatment has never been performed.
  
  
  OBJECTIVE
  To compare the efficacy of the PDL in the treatment of localized, recalcitrant plaque psoriasis with a potent topical therapy, using calcipotriol/betamethasone dipropionate (Dovobet) as an active comparator.
  
  
  METHODS
  Eight patients with psoriasis were treated with both PDL (585 nm) and calcipotriol/betamethasone dipropionate in an open, intrapatient, left-right comparison. A plaque severity score (sum score) and photographs were used to document the course of therapy. Patients reported pain on a visual analogue scale.
  
  
  RESULTS
  Both treatments were well tolerated, although one patient left the study due to post-PDL treatment pain. A significant difference in the sum score 12 weeks after treatment was seen in favour of the PDL (62% vs. 19% reduction; P<0.05). Scores for erythema declined significantly at week 12 in both the PDL and the calcipotriol/betamethasone dipropionate group (P<0.001). Induration and desquamation scores were significantly reduced at week 12 in the PDL group, without a statistically significant reduction in calcipotriol/betamethasone-treated lesions. The pain scores declined with progressive PDL treatments, although not statistically significantly.
  
  
  CONCLUSIONS
  PDL treatment might be considered for the treatment of localized, recalcitrant plaque psoriasis, when other topical therapies have failed.
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, René Descartesdreef 1, PO Box 9101, 6525 GL Nijmegen, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Erceg
authors.forename: H J
authors.initials: HJ
authors.lastname: Bovenschen
authors.forename: P C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: M M B
authors.initials: MM
authors.lastname: Seyger
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D004338:Drug Combinations; C055085:calcipotriene; D001623:Betamethasone; D002117:Calcitriol