The pulsed-dye laser as an adjuvant treatment modality in acne vulgaris: a randomized controlled single-blinded trial.
BACKGROUND
Acne vulgaris is the most common skin disease and can pose a substantial therapeutic challenge. Recently, several phototherapeutic modalities, most notably pulsed-dye laser (PDL) treatment, have been introduced, but the published results - albeit promising - are controversial.


OBJECTIVE
To assess the efficacy of an adjuvant PDL treatment when combined with a proven topical treatment [fixed-combination clindamycin 1%-benzoyl peroxide 5% hydrating gel (C/BPO)].


METHODS
Eighty patients (38 males and 42 females, mean +/- SD age 19.7 +/- 5.9 years) were randomized in a 1 : 2 ratio to receive C/BPO alone or in combination with PDL treatment (wavelength 585 nm, energy fluence 3 J cm(-2), pulse duration 0.35 ms, spot size 7 mm). Patients were evaluated at baseline and at 2 and 4 weeks after initial treatment. The primary end points were the Investigator's Static Global Assessment (ISGA) score and lesion count; the secondary end point was the Dermatology Life Quality Index (DLQI).


RESULTS
Both groups showed a significant improvement during observation [ISGA 27.1% (C/BPO) and 24.6% (C/BPO + laser), total lesion count 9.2% and 9.0%, inflammatory lesion count 36.3% and 36.9%, DLQI 54.5% and 42.5%], but there was no significant or otherwise appreciable difference between treatment modalities as far as the extent of improvement was concerned. Patients with more severe findings at baseline had a greater benefit from either therapy regimen.


CONCLUSIONS
Our findings do not support the concept of a substantial benefit of PDL treatment in acne vulgaris.
Karsai
S
S
Laserklinik Karlsruhe, Kaiserstr. 104, D-76133 Karlsruhe, Germany. SyrusKarsai@aol.com
Schmitt
L
L
Raulin
C
C
D000152:Acne Vulgaris / Q000628:therapy*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001585:Benzoyl Peroxide / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D016037:Single-Blind Method; D055815:Young Adult
D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D002981:Clindamycin; D001585:Benzoyl Peroxide