Korean J Dermatol.  2020 Nov;58(9):601-607.

A Gain-switched 311-nm Titanium:Sapphire Laser Treatment in Palmoplantar Pustulosis

• Oh YW
• Kim DH
• Seo BH
• Suh HS
• Choi YS

Abstract

Background
Palmoplantar pustulosis is a specific form of localized pustular psoriasis occurring on the palm and sole. Multiple therapeutic options, including topical and systemic agents as well as phototherapies, are available for palmoplantar pustulosis; however, treatment outcomes are not satisfactory in most cases. Recently, a gain-switched 311-nm Ti:Sapphire Laser was developed and showed good treatment response in vitiligo and atopic dermatitis.
Objective
To investigate the efficacy and safety of the 311-nm Ti:Sapphire Laser in the treatment of palmoplantar pustulosis.
Methods
A total of 24 patients with palmoplantar pustulosis were treated with a 311-nm Ti:Sapphire Laser twice a week for up to 32 sessions and had a 3-month follow-up visit. The treatment dose started at 300 mJ/cm 2 and was increased by 50 mJ/cm 2 at each subsequent session. The Palmoplantar Pustular Psoriasis Area and Severity Index score, 5-grade patient satisfaction score, and adverse events were evaluated.
Results
The mean Palmoplantar Pustular Psoriasis Area and Severity Index score decreased from 8.31±3.31 at baseline to 4.75±2.70 at 16 sessions, 3.26±2.18 at 32 sessions, and 4.05±2.19 at follow-up visit. In the subgroup analysis, non-smokers and emollients user groups showed better responses in Palmoplantar Pustular Psoriasis Area and Severity Index (p=0.033 and p=0.027, respectively). Adverse effects, including burning sensation and transient erythema, were limited and well-tolerated.
Conclusion
The 311-nm Ti:Sapphire Laser can be considered as a treatment option for palmoplantar pustulosis. Moreover, habitual risk factor modifications, such as smoking cessation and steady use of emollients, can impact treatment outcomes in patients with palmoplantar pustulosis.

Keyword

311-nm Ti:Sapphire laser; Palmoplantar pustulosis; Phototherapy