Background Current mainstay treatment of cutaneous lupus erythematosus (CLE) include topical corticosteroids, sun protection, and systemic treatment. Various non-medical alternative/adjunctive treatment have been reported such as cryotherapy, and laser therapy. Several studies have shown the efficacy of pulsed dye laser (PDL) for discoid lupus erythematosus (DLE). Additionally, there was a case report showing the efficacy of fractional photothermolysis for reminiscent scar of DLE.
Methods This was a retrospective study which included 20 CLE patients who visited the Department of Dermatology at Hanyang University Seoul Hospital in Korea between November 2016 and December 2022. Patient medical datas and clinical photographs were reviewed.
Results Of the 20 CLE patients, 15 (75%) underwent PDL, 7 (35%) underwent fractional laser, 9 (45%) underwent long-pulse neodymium-doped yttrium aluminium garnet (Nd:YAG), 4 (20%) underwent 532-nm Nd: YAG, and 2 (10%) were treated with intense pulsed light (IPL). The majority of patients had been taking hydroxychloroquine for several years. After a mean number of 2.4 sessions of PDL, patients showed improvement of telangiectasias and erythema, and there was mild improvement of atrophic and pigmented lesions. After a mean number of 3.1 sessions of fractional laser, there was improvement of scarring lesions of DLE. All treatments were well tolerated, and all patients did not show any worsening of disease. Also, none of our patients experienced any long-lasting side effects, such as photosensitivity, disease reactivation, or pigmentary defects.
Conclusions In general, laser treatments are still regarded as harmful in patients with underlying immunologic deficiency or autoimmune connective tissue disorder, since wound healing in these patients may be impaired. None of our patients, however, showed any worsening of skin lesion or side effects. It seems reasonable and safe to use laser treatments as an adjunctive treatment for cosmetic purpose to patients who achieve stable disease activity.
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