Name of the Procedure:

Laser treatment for inflammatory skin disease (psoriasis); total area less than 250 sq cm. Also known as Excimer laser therapy or targeted phototherapy for psoriasis.

Summary

Laser treatment for psoriasis involves the application of focused, high-intensity light to small, targeted skin areas affected by psoriasis. This precise approach helps to reduce inflammation and slow down the rapid skin cell growth characteristic of this condition.

Purpose

The primary purpose of laser treatment for psoriasis is to control and reduce the symptoms of psoriasis, such as redness, scaling, and thickened skin patches. The goal is to improve the appearance of the skin, relieve discomfort, and enhance the patient's quality of life.

Indications

This procedure is indicated for patients with moderate to severe localized psoriasis affecting a total area less than 250 square centimeters. It may be particularly useful for patients who have not responded well to topical treatments or those who prefer a non-systemic therapy option.

Preparation

• Patients may be instructed to avoid applying any topical treatments on the areas being treated on the day of the procedure.
• Wear protective goggles during the treatment to shield the eyes from the laser light.
• No fasting or significant medication adjustments are typically required.
• A thorough medical evaluation and possibly a skin biopsy might be conducted to establish the diagnosis and to rule out other conditions.

Procedure Description

1. The patient is positioned comfortably, and the affected skin area is exposed.
2. Protective measures such as goggles are provided to both the patient and healthcare providers.
3. The Excimer laser device is calibrated and directed at the psoriasis plaques.
4. Short bursts of ultraviolet B (UVB) light are administered to the targeted areas.
5. The duration of laser exposure is carefully controlled to minimize damage to surrounding healthy tissue.
6. The entire process is repeated across all affected areas within the designated treatment region.

Duration

Each session typically lasts between 10 to 30 minutes, depending on the size and number of areas being treated.

Setting

The procedure is commonly performed in an outpatient clinic, a dermatologist's office, or a dedicated laser treatment center.

Personnel

The procedure is usually performed by a dermatologist or a trained healthcare provider specializing in laser treatments for skin conditions. Nurses and medical assistants may assist.

Risks and Complications

• Redness, blistering, or itching at the treatment site.
• Temporary hyperpigmentation or hypopigmentation.
• Rarely, scarring or infection.
• Management of these complications includes topical treatments and proper wound care.

Benefits

• Reduces the symptoms of psoriasis, leading to smoother, clearer skin.
• Targeted treatment minimizes exposure to healthy skin.
• Non-invasive with minimal discomfort during and after the procedure.
• Improvement in skin appearance and relief of symptoms can be seen within a few weeks after starting treatment.

Recovery

• Patients can immediately resume normal activities post-procedure.
• Light redness or irritation may occur but usually resolves within a few hours to days.
• Moisturizers and gentle skin care practices are recommended.
• Follow-up sessions may be required every 1-2 weeks, as determined by the dermatologist.

Alternatives

• Topical treatments (e.g., corticosteroids, vitamin D analogs).
• Phototherapy (e.g., narrow-band UVB, PUVA).
• Systemic medications (e.g., methotrexate, cyclosporine, biologics).
• Each alternative comes with its own set of benefits and risks, and the choice depends on the severity of the condition and patient preferences.

Patient Experience

During the procedure, patients may feel a slight warm or tingling sensation. Pain is usually minimal and can be managed with topical anesthetics if necessary. Post-procedure, mild redness or irritation can occur but typically resolves shortly. The patient should follow post-care instructions to ensure optimal results and minimize side effects. Regular follow-up visits will be necessary to monitor progress and adjust treatment as needed.