Doi:10.1016/j.jaad.2004.05.026

308-nm excimer laser therapy in alopeciaareata To the Editor: Alopecia areata (AA) is believed to bea T-cell autoimmune disorder, and 308-nm excimerlaser is able to induce T-cell apoptosis in vitro,suggesting that this laser might be effective intreating this disease. We have performed a compar-ative prospective intraindividual study to access theeffectiveness of the 308-nm excimer laser in thetreatment of AA.
Nine patients were included in the study. The laser used was a 308-nm excimer laser (Talos,Wavelight Germany). Each lesion was treated twice a weekfor a maximum of 24 sessions. Initial fluencies were Fig 1. A, Alopecia areata patches before treatment. B, 50 mJ/cm2 less than minimal erythema dose. Then fluencies were increased from 50 mJ/cm2 every twosessions. Each treated lesion had an opposite side comparisons between the results obtained from these untreated target lesion serving as a control.
various treatments are difficult because of the hetero- Tolerance was evaluated with a visual analogue geneity of AA in its presentation and its responses to scale (0 = poor, 10 = excellent). Efficacy was blindly treatments. Thanks to its good tolerance, pho- evaluated by two independent physicians on direct- totherapy is an attractive treatment. Several studies light photos (Fujifilm Finepix S1 Pro; Fujifilm Ltd, have been reported concerning the efficacy of sys- Tokyo, Japan) taken before sessions, at the end of temicand topical psoralen-UVA therapin the the sessions, and 3 months after sessions. Regrowth treatment of AA. Paradoxical response rates were was graded on a 6-point scale (0 = no hair regrowth, reported in the literature. Interestingly, preliminary 1 = hair regrowth 1%-24%, 2 = hair regrowth 25%- efficacy of narrowband UVB phototherapy for AA was 49%, 3 = hair regrowth 50%-74%, 4 = hair regrowth reported recently in a left-right monitored pilot stud 75%-99%, and 5 = complete hair regrowth). At the This report underscores the potential efficiency of final visit, the patients’ opinions about treatment effectiveness and the degree of satisfaction were In conclusion, the 308-nm excimer laser appears recorded (excellent, good, moderate, poor).
to be a good therapeutic alternative for AAP.
The results are summarized in . Our study Nevertheless, additional monitored studies on shows that 308-nm excimer laser induces effective a larger population are necessary to validate our hair regrowth in all patients with alopecia areata partialis (AAP) ). The occurrence of hair re- growth only on the treated patches proves the efficiency of this therapy and excludes the possibility of spontaneous hair regrowth that should be always considered when evaluating AA treatments. None of these patients lost their hair over a follow-up period of Department of Dermatology, Hoˆpital de l’Archet 3 months. On the other hand, no hair regrowth was observed in patients with either alopecia areatauniversalis (AAU) or alopecia areata totalis (AAT).
Moreover, the small size of the hand piece (maximum Department of Dermatology, Archet-2 hospital 25-mm diameter) makes the treatment of the entire scalp long and tiresome. These results are in agree- ment with the prognosis factors usually observed inAA. Interestingly, only a few sessions were necessaryto obtain aesthetically correct results in AAP. Theseresults were obtained from moderate accumulated REFERENCES1. Novak Z, Bonis B, Baltas E, Ocsovszki I, Ignacz F, Dobozy A, et al.
doses. The side effects were limited to mild erythema Xenon chloride ultraviolet B laser is more effective in treating and hyperpigmentation, and the tolerance was excel- psoriasis and in inducing T cell apoptosis than narrow-band lent. Many therapies have been tried for AA, but ultraviolet B. J Photochem Photobiol B 2002;67:32-8.
(0%); minoxidil5% (0%); systemicsteroid (0%) AA, Alopecia areata; F, female; M, male; MED, minimal erythema dose.
Hair regrowth: 0 = no hair regrowth, 1 = hair regrowth 1% to 24%, 2 = hair regrowth 25% to 49%, 3 = hair regrowth 50% to 74%, 4 = hairregrowth 75% to 99%, and 5 = complete hair regrowth.
2. Claudy AL, Gagnaire D. PUVA treatment of alopecia areata. Arch A 34-year-old woman in the third month of pregnancy presented with facial erythema and pru- 3. Taylor CR, Hawk JL. PUVA treatment of alopecia areata partialis, ritic papules on the dorsal hands, elbows, and knees.
totalis and universalis: audit of 10 years’ experience at St John’sInstitute of Dermatology. Br J Dermatol 1995;133:914-8.
The rash had appeared at 4 weeks’ gestation. She had 4. Behrens-Williams SC, Leiter U, Schiener R, Weidmann M, Peter not taken any medicine before the rash appeared.
RU, Kerscher M. The PUVA-turban as a new option of applying She did not complain of muscle pain or weakness. In a dilute psoralen solution selectively to the scalp of patients her first pregnancy, she delivered a healthy baby and with alopecia areata. J Am Acad Dermatol 2001;44:248-52.
had had no cutaneous complications. There was no 5. Bolduc C, Hobbs L, Shapiro J, McLean D, Lui H. Efficacy of narrow-band UVB in the treatment of alopecia areata. Poster personal or family history of connective tissue presented at: Third Intercontinental Meeting of Hair Research Examination revealed discrete pruritic red-purple papules over the bony prominences. Periungual telangiectasia was also observed. She had exudativeerythema bridging the nose (Fig 1). A skin biopsyspecimen from her elbow was compatible with DM(Fig 2). Results of complete blood counts, blood biochemistry analysis, and urinalysis were within normal limits. Although antinuclear antibody titer To the Editor: Amyopathic dermatomyositis (ADM) (1:40) was positive in a nucleolar pattern, other presents with pathognomonic cutaneous manifesta- autoantibodies were negative. Based on these tion of dermatomyositis (DM) but without associated findings, this patient was diagnosed with ADM.
skeletal muscle involvement. ADM associated with Potent topical steroids were prescribed but the eruption did not improve. She delivered a healthy

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