Excimer Laser

Excimer 308-nm light is a type of targeted phototherapy that uses an excimer laser or an excimer lamp to deliver a specific wavelength (308 nm) of ultraviolet B (UVB) radiation. Both have similar efficacy outcomes, however there are technical variances.

 

What is excimer 308-nm light treatment?

Excimer light therapy is a progression of whole-body narrowband UVB treatment. For the treatment of localized psoriasis and vitiligo, narrowband UVB emits light with a wavelength of 311–312 nm. Irradiation of the entire body (even if the psoriasis is localized) and the requirement for a large number of treatments are two downsides of narrowband UVB (usually between 15 and 40 sessions).

The UV ray generated by the excimer light is delivered via a hand-held wand that focuses on the lesion. Compared with narrowband UVB, its advantages are:

  • In some cases, a shorter course of treatment is effective
  • Healthy skin surrounding the affected areas is not exposed to radiation
  • A higher dose of radiation can be delivered, with a reduced cumulative dose of irradiation
  • Different templates are used according to the area to be treated
  • It can be used in areas difficult to reach with conventional phototherapy, such as ears and genitals
  • It can be used in children, as it is a relatively friendly–looking piece of equipment.
  • What are the indications for excimer 308-nm light treatment?

    Excimer laser therapy can be used to treat localized vitiligo and moderately severe localized psoriasis that has not responded to topical therapies. It is frequently used with topical treatments, such as topical calcineurin inhibitors and topical steroids, to improve responsiveness.

    In these circumstances, more controlled trials are needed to compare excimer light therapy to topical therapies and other laser treatments. In addition, studies will be conducted to determine the effectiveness and safety of treatments in the short and long term, as well as to find the best dosage regimens and patient selection criteria.

    It’s been used for localized severe atopic eczema, alopecia areata, cutaneous T-cell lymphoma, localized scleroderma, and granuloma annulare, according to some case reports.

    What are the side effects of excimer light treatment?

    Excimer light is generally well tolerated. The goal of treatment is to administer a dose that causes noticeable redness in the psoriatic lesion (supra-erythematous dose) without causing blisters or second-degree burns. If the dose is too high, it creates blisters on the treated areas.

    Other side effects include:

  • Koebnerisation (development of skin lesions due to trauma in case of a burn)
  • Erosions
  • Reactivation of herpes virus infection.
  • Hyperpigmentation
  • Painful erythema
    • Skin ageing and skin cancer are caused by long-term exposure to UV light. Although the dangers of excimer laser therapy are unknown, research suggests it is safer than narrowband UVB since it does not expose the entire body to UV radiation.

      What does the treatment involve?

      There are currently no generally established disease-specific excimer light treatment regimens.

      Patients come 1–3 times each week. The amount of UV provided is calculated and monitored carefully, taking into account the skin type, age, condition, location, and treatment response.

      The treatment time is less than with whole-body phototherapy. Some response may be shown as early as 6–8 treatments, with a complete response taking 20–30 treatments. The usual treatment time is around seven weeks.

      Some patients go into remission for a long time, while others relapse in 3–6 months.

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