Excimer laser versus clobetason propionaat in prurigo form of atopic dermatitis.

Background:

(UVB) phototherapy is widely recognised as effective treatment modality for patients with chronic atopic dermatitis (AD). Recent findings establish the 308 xenon chloride (XeCl) excimer laser to be a new option in the area of UVB phototherapy. The XeCl excimer laser enables large fluences of narrow-band (NB) UVB and precise targeting of effected skin. As NB-UVB is known to be effective in AD, the excimer laser appears to be a promising treatment for localized AD.


Objectives:

Primary, to investigate the efficacy of XeCl excimer laser therapy versus topical corticosteroid in a side-to-side comparison in patients with the prurigo form of AD. Secondary, to assess the duration of remissions achieved with excimer laser and to evaluate the patient¡¯s and investigator¡¯s satisfaction/preferences regarding both treatments.


Study design:

Prospective single blind randomised within-patient controlled study.


Patients and methods:

Adult patients > 18 years diagnosed with a prurigo form of AD at the Depatment of Dermatology of the AMC, who meet the inclusion criteria, will be included. All patients will be randomized to a within-patient left-right comparison study of excimer laser versus topical clobetason propionaat. Treatment with the ecximer laser will be performed twice a week, during a treatment period of 10 weeks, Clinical responses will be evaluated using Physician Assessment of Individual Signs (PAIS) (number of nodules, elevation of nodules, excoriation, erythema and pruritus), photographic documentation, Physician Global assessment (PGA) and Patient Global Assessment (PaGA). Besides the clinical responses, the patient and physician satisfaction/preference and duration of remission will be evaluated.

As NB-UVB is known to be effective in AD, the excimer laser appears to be a promising treatment for localized AD. We designed a randomized single blind within-patient controlled trial to investigate the efficacy of the excimer laser versus routine topical corticosteroid, clobetason propionaat.

N/A

All patients will be randomized to a within-patient left-right comparison study of excimer laser versus topical clobetason propionaat. Treatment with the ecximer laser will be performed twice a week, during a treatment period of 10 weeks. Clobetason propionaat will be applied by the patients themselves once a day , according standardised instructions, during a treartment period of 10 weeks.