title: Plaque-based sub-blistering dosimetry: Reaching PASI-75 after two treatments with 308-nm excimer laser in a generalized psoriasis patient.
abstract: BACKGROUND
  Generalized UVB phototherapy has been established as an effective and safe treatment for chronic plaque-type psoriasis for decades and in recent years, targeted 308-nm excimer laser has emerged as an equally safe and more effective treatment option. While traditional dosimetry for laser has been determined either through minimal erythema dose (MED) or a combination of the patient's Fitzpatrick skin type and the level of plaque induration, we have developed "Plaque-based Sub-blistering Dosimtery" based on observations that administering anywhere from 8 to 16 multiples of MED to psoriatic plaques has resulted in clearance after one treatment with longer remission rates than the traditional dosing protocol.
  
  
  METHODS
  The authors describe a case in which a patient achieved PASI 75 following only two treatments with 308 nm excimer laser using this new protocol. Biopsies taken before and after treatment reveal a dramatic decrease in CD4+T cells as well as TNF-alpha- and IL-2-producing T cells.
  
  
  CONCLUSIONS
  This case demonstrates using a more aggressive dosing protocol determined by plaque testing is well-tolerated and can lead to excellent clearance with minimal side effects and comorbidity.
authors.affiliation: School of Medicine, University of California , Irvine, CA , USA and.
authors.forename: Maya G
authors.initials: MG
authors.lastname: Debbaneh
authors.forename: Ethan
authors.initials: E
authors.lastname: Levin
authors.forename: Robert
authors.initials: R
authors.lastname: Sanchez Rodriguez
authors.forename: Argentina
authors.initials: A
authors.lastname: Leon
authors.forename: John
authors.initials: J
authors.lastname: Koo
authors.forename: Michael D
authors.initials: MD
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D011565:Psoriasis / Q000473:pathology / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods
keywords: Excimer; laser; plaque-based; psoriasis; sub-blistering