Excimer laser vs. clobetasol propionate 0·05% ointment in prurigo form of atopic dermatitis: a randomized controlled trial, a pilot.
BACKGROUND
Recent findings have established the 308-nm xenon chloride excimer laser (EL) as a new option in the area of ultraviolet (UV) B phototherapy. As this laser enables high radiant exposure of narrowband UVB and precise targeting of affected skin, it appears to be a promising treatment for the prurigo form of atopic dermatitis (AD).


OBJECTIVE
To investigate the efficacy and safety of the EL compared with clobetasol propionate (CP) in the prurigo form of AD.


METHODS
In a prospective randomized within-patient controlled study, 13 patients with a prurigo form of AD were randomized to receive EL on one side and topical CP on the other side. Laser treatment was performed twice a week for 10 weeks. Clinical responses were evaluated using Physician Assessment of Individual Signs, Physician Global Assessment, Patient Global Assessment and photographic documentation. Histopathological changes were evaluated and duration of remission was monitored during a 6-month follow-up period.


RESULTS
Both treatments resulted in a significant improvement of all outcome measures after 10 weeks of treatment. During follow up, the EL showed more improvement compared with CP. Histopathology demonstrated marked decrease of epidermal thickness and inflammatory infiltrate at the EL-treated sites. No significant side-effects occurred.


CONCLUSIONS
This study suggests that the EL can safely and effectively be used in the treatment of the prurigo form of AD. For the long term, the EL might be a good alternative to topical corticosteroids and an option in case of therapy-resistant patients.
Brenninkmeijer
E E A
EE
Department of Dermatology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, the Netherlands. E.E.Brenninkmeijer@amc.uva.nl
Spuls
P I
PI
Lindeboom
R
R
van der Wal
A C
AC
Bos
J D
JD
Wolkerstorfer
A
A
D000328:Adult; D000368:Aged; D001706:Biopsy; D002990:Clobetasol / Q000009:adverse effects / Q000627:therapeutic use*; D003876:Dermatitis, Atopic / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D054018:Lasers, Excimer / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011536:Prurigo / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D003879:Dermatologic Agents; D005938:Glucocorticoids; D002990:Clobetasol