Combination strategy may change psoriasis treatment

Key Points

San Francisco - In early testing, an experimental protocol combining excimer laser (XTRAC Velocity, PhotoMedex), clobetasol spray and topical calcitriol ointment achieves fast, impressive results in patients with severe generalized psoriasis.

With this protocol, "We are not only trying to make phototherapy almost as convenient as systemic options, without any serious internal side effects, but we're also aiming higher," says John Y.M. Koo, M.D., professor and vice chairman, department of dermatology, University of California, San Francisco. "I believe we can make people better faster this way than with the typical biologic or methotrexate. Even though we've only treated two patients, the fundamental concept is that clobetasol spray and excimer laser work well on their own. Together, they work like gangbusters."

By combining the excimer laser with a topical steroid, she says, "We can be more aggressive with the laser therapy, because we're providing an anti-inflammatory agent at the same time."

Specifically, Dr. Bhutani says, "We can treat 10 to 20 percent body surface area in an average of 10 minutes." Dr. Koo says the treatment is very quick "only if you have the right machine. The Velocity laser is at least three times more powerful than its predecessor."