Laser treatment for inflammatory skin disease (psoriasis); over 500 sq cm
CPT4 code
Name of the Procedure:
Laser Treatment for Inflammatory Skin Disease (Psoriasis)
Common name: Laser treatment for psoriasis
Technical term: 308 nm excimer laser therapy
Summary
Laser treatment for psoriasis is a non-invasive procedure that utilizes targeted ultraviolet B (UVB) light to reduce the symptoms and flare-ups of psoriasis over large areas of the skin, specifically over 500 square centimeters.
Purpose
This procedure addresses the chronic inflammatory skin condition psoriasis, which causes red, scaly, and itchy patches on the skin.
- Goals: Reduce symptoms, clear skin plaques, and achieve longer remission periods.
Indications
- Symptoms: Persistent red, scaly patches of skin usually found on the elbows, knees, scalp, and torso.
- Conditions: Moderate to severe psoriasis unresponsive to topical treatments.
- Patient Criteria: Suitable for patients with affected skin areas larger than 500 sq cm and those unable to tolerate systemic medications.
Preparation
- Pre-procedure: Clean the affected area.
- Diagnostic Tests: Physical examination and possibly skin biopsy to confirm diagnosis.
Procedure Description
- The patient is positioned comfortably, ensuring exposed areas to be treated are accessible.
- Protective eyewear is provided to shield both the patient and operator from UV light.
- The laser device is adjusted for the specific dose and wavelength.
- The operator directs the laser to the psoriasis-affected areas, delivering precise UVB light.
- Each targeted area is exposed for a brief duration to ensure effective treatment.
Tools and Equipment:
- 308 nm excimer laser device.
Protective eyewear.
Duration
The procedure typically takes between 20 to 30 minutes, depending on the size and number of areas treated.
Setting
The procedure is usually performed in an outpatient clinic or a dermatology office.
Personnel
- Dermatologist or trained healthcare provider (operator).
- Medical assistant or nurse (support staff).
Risks and Complications
Common Risks:
- Skin redness and irritation.
- Mild discomfort during and after treatment.
Rare Risks:
- Blistering or hyperpigmentation.
- Infections at the treatment site.
Management:
- Topical soothing agents may be applied to alleviate discomfort.
- Follow-up consultations to monitor skin response.
Benefits
- Significant reduction in psoriasis symptoms.
- Clearer skin within several treatment sessions.
- Long-term remission periods.
Recovery
- Post-procedure Care: Apply moisturizers and avoid direct sun exposure.
- Recovery Time: Minimal; patients can return to daily activities immediately.
- Follow-Up: Regular sessions may be required initially, followed by periodic maintenance treatments.
Alternatives
- Topical treatments: Creams and ointments (less effective for extensive psoriasis).
- Systemic medications: Oral or injectable treatments (may have more side effects).
- Light therapy: Broad-band UVB or PUVA (photochemotherapy).
Pros and Cons:
- Alternatives might be less targeted and have a longer response time. However, laser treatment offers focused, quick relief but could require multiple sessions.
Patient Experience
During the Procedure:
- Minimal discomfort with a slight warming sensation.
After the Procedure:
Mild redness or irritation, similar to a mild sunburn, which usually subsides within a day.
Pain Management:
Pain is generally minimal and can be managed with over-the-counter analgesics if necessary.