Carbon dioxide laser treatment for Hailey-Hailey disease: a retrospective chart review with patient-reported outcomes.
BACKGROUND
Hailey-Hailey disease (HHD) is an autosomal dominant genodermatosis that leads to skin breakdown and blister formation, usually in intertriginous areas. Laser ablation is a known surgical treatment for HHD.


OBJECTIVE
We report outcomes in a series of patients with HHD treated with carbon dioxide (CO2 ) laser ablation.


METHODS
A retrospective chart review of data for 13 patients who underwent CO2 laser ablation for HHD was conducted. Questionnaires assessing effectiveness, pain, healing time, recurrence, new disease, complications, additional ablation, improvement in quality of life (QoL), and overall satisfaction were completed by all patients.


RESULTS
All patients had been recalcitrant to previous treatments prior to CO2 laser ablation. Anatomic sites treated and anesthesia techniques for the procedure varied. The mean ± standard deviation (SD) score for the effectiveness of CO2 laser ablation for HHD was 9.3 ± 0.9 (maximum: 10). All patients reported improved QoL. No patient had recurring disease within the treatment field. Five patients underwent additional CO2 laser treatments at new sites. One patient reported postoperative infection. No other complications were identified. The mean ± SD score for overall satisfaction with CO2 laser ablation was 8.9 ± 1.1.


CONCLUSIONS
Treatment with CO2 laser ablation is very effective and can lead to prolonged or permanent remission in most HHD patients. Patients are highly satisfied with the results and report a substantial improvement in QoL.
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Phillip C
PC
Hochwalt
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Kevin N
KN
Christensen
Mayo Medical School, Mayo Clinic, Rochester, MN, USA.
Sean R
SR
Cantwell
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Thomas L
TL
Hocker
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Clark C
CC
Otley
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Jerry D
JD
Brewer
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Christopher J
CJ
Arpey
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Randall K
RK
Roenigk
Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
Christian L
CL
Baum
D055011:Ablation Techniques / Q000009:adverse effects; D000328:Adult; D002245:Carbon Dioxide; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D016506:Pemphigus, Benign Familial / Q000601:surgery*; D011788:Quality of Life; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
D002245:Carbon Dioxide