A pilot study showing pulsed-dye laser treatment improves localized areas of chronic atopic dermatitis.

BACKGROUND Eczematous skin changes overlying port-wine stains have been reported to improve with pulsed-dye laser (PDL) treatment. However, PDL has not as yet been evaluated for the treatment of atopic dermatitis (AD; eczema). AIM To evaluate in a controlled trial the effects and safety of PDL treatment in children with AD who had chronic localized lesions. METHODS Twelve children with localized, chronic eczema were treated with PDL (595 nm), with untreated areas used as an intrapatient control. Treatment was given at baseline and patients were followed up at 2 and 6 weeks. Clinical outcome measures were localized Eczema Severity Score (ESS), a visual analogue scale (VAS) indicating eczema severity assessed by photographs, and adverse events. RESULTS After 2 and 6 weeks, a significant decrease in ESS was seen for the PDL-treated areas compared with the control areas (mean +/- SEM reduction in ESS 7.0 +/- 1.0 vs. 3.3 +/- 0.8 at 2 weeks, P = 0.003, and 7.8 +/- 1.4 vs. 4.9 +/- 1.3 at 6 weeks, P = 0.002). A significant difference in eczema severity assessed by VAS at 6 weeks was seen in favour of PDL (mean +/- SEM improvement 78% +/- 20% vs. 52% +/- 10%, P = 0.003). Treatment was well-tolerated. CONCLUSIONS In this pilot study, PDL treatment was effective in treating small areas of chronic localized eczema. This may suggest that in AD dermal vasculature plays an important role or that PDL may have an effect on cutaneous immunological activation.