CO2 lasers may be particularly useful in the treatment of digital BD lesions. Clearance rates in the small uncontrolled trials were high, with acceptable recurrence rates during follow up periods of sufficient duration. The suitability of CO2 laser therapy for digital BD relates principally to two properties. First, CO2 laser has the ability to vaporise the epidermis and the upper papillary dermis, leading to healing with minimal scar formation. This feature is desirable in mobile areas such as the fingers where cicatricial contracture following excision may lead to functional impairment. Second, the concern that CO2 lasers may not penetrate to a sufficient depth to eradicate perifollicular BD is obviated by the paucity of hair on the fingers. The risk of recurrence secondary to perifollicular involvement is therefore less of a concern in digital lesions than in lesions at other body sites. CO2 lasers may thus be helpful for digital lesions where more conventional and less costly therapies have failed.

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