Excimer laser therapy and narrowband ultraviolet B therapy for exfoliative cheilitis☆☆☆

BACKGROUND Exfoliative cheilitis is a condition of unknown etiology characterized by hyperkeratosis and scaling of vermilion epithelium with cyclic desquamation. It remains largely refractory to treatment, including corticosteroid therapy, antibiotics, antifungals, and immunosuppressants. OBJECTIVE We sought to evaluate the safety and efficacy of excimer laser therapy and narrowband ultraviolet B therapy in female patients with refractory exfoliative cheilitis. METHODS We reviewed the medical records of two female patients who had been treated unsuccessfully for exfoliative cheilitis. We implemented excimer laser therapy, followed by hand-held narrowband UVB treatments for maintenance therapy, and followed them for clinical improvement and adverse effects. RESULTS Both patients experienced significant clinical improvement with minimal adverse effects with excimer laser therapy 600-700 mJ/cm2 twice weekly for several months. The most common adverse effects were bleeding and burning, which occurred at higher doses. The hand-held narrowband UVB unit was also an effective maintenance tool. LIMITATIONS Limitations include small sample size and lack of standardization of starting dose and dose increments. CONCLUSION Excimer laser therapy is a well-tolerated and effective treatment for refractory exfoliative cheilitis with twice weekly laser treatments of up to 700 mJ/cm2. Transitioning to the hand-held narrowband UVB device was also an effective maintenance strategy.