Psoriasis
Psoriasis is a chronic (long-lasting) disease in which the immune system becomes overactive, causing skin cells to multiply too quickly. As a result, patches of skin become scaly and inflamed, most often on the scalp, elbows, or knees, but other body parts can also be affected.⁽¹⁾
Severe forms are very disabling and need systemic treatments. Localized forms of psoriasis, however, can be difficult to treat or frequently recur, leading to decreased quality of life and psychological distress.⁽²⁾
Treatment Protocol
Pre-Treatment Procedure
- Remove flakes if necessary.
- Remove any cosmetics.
- Choose the correct eye protection.
- MED Test:
- MED test is carried at healthy tissues at first consultation (for instance, at the forearm, using the smallest patch size).
- MED level is determined after 24 hours, where the patch with light erythema and clear demarcated borders is the correct level.
Treatment Procedure
- Start treatment at two to three times MED, depending on the thickness of the plaques.
- Increase in steps of one MED per consultation as long as tolerable for the patient.
- Stay at “max” tolerable fluence level.
- No blister formation should occur.
- If crusting or blistering occurs, decrease energy by one MED and stay at this ”max” fluence for the subsequent two sessions. Then, start increasing afterward by 100 mJ/cm² every second session.
- Apply the dose to the affected skin only.
- No overlap.
Post-Treatment Procedure
- The use of moisturizer is recommended.
Pictures
Before and after four treatments
Treatment Video
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Contraindications
(excerpt only, all contraindications and side effects are listed in the user manual)
- Dermatosis with Koebner phenomenon
- Auto-immune light-sensitive dermatoses: Lupus, Dermatomyositis
- Elevated photo-sensitivity
- Photo-sensitizing medication
- Photogen dermatosis, photodermatosis
- Personal or family anamnesis of melanoma
- Pregnancy (no study available)
- Cutaneous infection in the treatment area
References
- ^ “Psoriasis”. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved 02 February 2023.
- ^ “Use of the 308-nm excimer laser for psoriasis and vitiligo”. Science Direct. Retrieved 02 February 2023.
Short Protocol
| Parameter: | Fluence: Start with 2-3 x MED ↑ 1 MED per # |
| Clinical endpoint: | Endpoint is erythema No crusting No blistering |
| Treatment cycle: | 2 # per week Minimum 48 hour interval |
| Estimated total number of treatments: | 10 – 20 # |
| Expected results: | Clearing of the target plaques |
Annotations
- For thick patches it is recommended to apply salicylic acid cream in the evening before the treatment.
- Make sure there is at least a 48 hour interval between treatments.
Note:
The FlexSys may only be used if the user has been trained to work correctly with the device following the operating instructions. The treatment parameters proposed by the device are merely a non-binding recommendation based on experience with the system and suggestions only! The physician is ultimately responsible for determining the appropriate parameters for each patient.
