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Proven Lupus Treatment By Dr Gary Levin

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There are no systematic reviews or RCTs of the role of flashlamp pulsed dye laser therapy in the treatment of cutaneous sarcoidosis. Four case reports were found. Goodman71 reported a woman with a 5-year history of lupus pernio of the nose who responded to laser therapy at an energy level of 7-8 J/cm2. The improvement induced by the laser was temporary: the erythema and papules returned 7 months after the first treatment, and 6-15 months after the second treatment, but both times responded again to laser therapy. She received three sessions altogether, and no side-effects of therapy (such as atrophy, scarring or hypopigmentation) were noted in any session.

Cliff et a/.72 described a patient with lupus pernio of the nose, who improved following six treatment sessions at 6-week intervals with flashlamp pulsed dye laser at a setting of 5-6-7-3 J/cm2. A biopsy of her nose after treatment noted the continued presence of non-caseating sarcoid granulomas, leading the authors to conclude that laser therapy was effective in improving the appearance of the lesions, but not the underlying disease process. Dosik et al.73 report on a woman with a 3-year history of topical and intralesional steroid-resistant lupus pernio who responded successfully to flashlamp pulsed dye laser at an energy of 7-25 J/cm2. The therapy was given for nine sessions at 1-2-month intervals.

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