Laser therapy for cutaneous sarcoidosis: A review

  • Teo Soleymani The Ronald O. Perelman Department of Dermatology, NYU School of Medicine
  • Michael Abrouk Department of Dermatology, University of California, Irvine, Irvine, California, USA
Keywords: Skin cancer, basal cell carcinoma, squamous cell carcinoma, lasers, PDL, ablative lasers, vascular lasers, CO2 laser

Abstract

Sarcoidosis is a systemic, multi-organ disease of unknown etiology characteristically defined by the development of non-caseating granulomas. The development of sarcoidosis has been associated with a number of environmental and microbacterial factors coupled with genetic susceptibility. Depending on the type, location and distribution of disease, sarcoidosis can cause functional impairment, symptomatic distress, scarring and disfigurement. The advent of lasers as precise, minimally destructive surgical tools has allowed for their development as promising alternatives that minimize the morbidity associated with current therapies.

In this paper, we reviewed the role of laser therapy in the treatment of cutaneous sarcoidosis. A comprehensive search of the Cochrane Library, MEDLINE and PUBMED databases was performed to identify relevant literatures investigating the role of laser therapy in the treatment of cutaneous sarcoidosis. In our opinion, laser therapy, particularly PDL, appears to be an effective, safe and generally well-tolerated modality for the treatment of cutaneous sarcoidosis and should be considered in patients with localized cutaneous disease that is refractory to conventional treatments. Less is known about the efficacy and tolerability of ablative laser therapy for the treatment of cutaneous sarcoidosis, though the limited data appears promising as well. With that said, however, the data is limited and warrants a need for additional larger, randomized controlled studies to further investigate the utility and efficacy of laser therapy in the treatment of cutaneous sarcoidosis.

References

Haimovic A, Sanchez M, Judson MA, Prystowsky S. Sarcoidosis: A comprehensive review and update for the dermatologist: Part I. Cutaneous disease. J Am Acad Dermatol 2012; 66(5): 699.e1–699.e18; quiz 717–718. doi: 10.1016/j.jaad. 2011.11.965.

Brownell I, Ramirez-Valle F, Sanchez M, Prystowsky S. Evidence for mycobacteria in sarcoidosis. Am J Respir Cell Mol Biol 2011; 45(5): 899–905. doi: 10.1165/rcmb.2010- 0433TR

Chen ES, Moller DR. Sarcoidosis — Scientific progress and clinical challenges. Nat Rev Rheumatol 2011; 7(8): 457– 467. doi: 10.1038/nrrheum.2011.93.

Hosoda Y, Sasagawa S, Yasuda N. Epidemiology of sar-coidosis: New frontiers to explore. Curr Opin Pulm Med 2002; 8(5): 424–428. doi: 10.1097/00063198-200209000- 00014.

Rybicki BA, Major M, Popovich J Jr, Maliarik MJ, Ian-nuzzi MC. Racial differences in sarcoidosis incidence: A 5-year study in a health maintenance organization. Am J Epidemiol 1997; 145(3): 234–241. doi: 10.1093/oxford-jour¬nals.aje.a009096.

Reich JM, Johnson RE. Incidence of clinically identified sarcoidosis in a northwest United States population. Sar-coidosis Vasc Diffuse Lung Dis 1996; 13(2): 173–177.

Bresnitz EA, Strom BL. Epidemiology of sarcoidosis. Epidemiol Rev 1983; 5: 124–156.

Pietinalho A, Hiraga Y, Hosoda Y, Lofroos AB, Yamaguchi M, et al. The frequency of sarcoidosis in Finland and Hokkaido, Japan. A comparative epidemiological study. Sarcoidosis 1995; 12(1): 61–67.

Mana J, Marcoval J, Graells J, Salazar A, Peyri J, et al. Cutaneous involvement in sarcoidosis. Relationship to sys-temic disease. Arch Dermatol 1997; 133(7): 882–888. doi: 10.1001/archderm.1997.03890430098013.

Lodha S, Sanchez M, Prystowsky S. Sarcoidosis of the skin: A review for the pulmonologist. Chest 2009; 136(2): 583–596. doi: 10.1378/chest.08-1527.

Costabel U, Guzman J, Baughman RP. Systemic evaluation of a potential cutaneous sarcoidosis patient. Clin Dermatol 2007; 25(3): 303–311. doi: 10.1016/j.clindermatol.2007.03. 008.

Anderson RR, Parrish JA. Selective photothermolysis: Precise microsurgery by selective absorption of pulsed ra-dia¬tion. Science 1983; 220(4596): 524–527. doi: 10.1126/sci¬¬ence.6836297.

Anderson RR. Lasers for dermatology and skin biology. J Invest Dermatol 2013; 133: E21–E23. doi: 10.1038/skinbio. 2013.181.

Jalian HR, Avram MM, Stankiewicz KJ, Shofner JD, Tannous Z. Combined 585 nm pulsed-dye and 1,064 nm Nd:YAG lasers for the treatment of basal cell carcinoma. La¬sers Surg Med 2014; 46(1): 1–7. doi: 10.1002/lsm.22201.

Sanchez M, Prystowsky S. Sarcoidosis of the skin [Inter-net]. Basow D (editor), Waltham (MA): UpToDate Online; 2010. Available from: www.uptodate.com.

James DG. Lupus pernio. Lupus 1992; 1(3): 129–131. doi: 10.1177/096120339200100302

Cliff S, Felix RH, Singh L, Harland CC. The successful treatment of lupus pernio with the flashlamp pulsed dye laser. J Cutan Laser Ther 1999; 1(1): 49–52. doi: 10.1080/14628839950517101.

Goodman MM, Alpern K. Treatment of lupus pernio with the flashlamp pulsed dye laser. Lasers Surg Med 1992; 12(5): 549–551. doi: 10.1002/lsm.1900120515.

Shaw M, Black MM, Davis PK. Disfiguring lupus pernio successfully treated with plastic surgery. Clin Exp Derma-tol 1984; 9(6):614–617.

Roos S, Raulin C, Ockenfels HM, Karsai S. Successful treatment of cutaneous sarcoidosis lesions with the flash-lamp pumped pulsed dye laser: A case report. Dermatol Surg 2009; 35(7): 1139–1140. doi: 10.1111/j.1524-4725. 2009.01202.

Holzmann RD, Astner S, Forschner T, Sterry G. Scar sarcoidosis in a child: Case report of successful treatment with the pulsed dye laser. Dermatol Surg 2008; 34(3): 393–396. doi: 10.1111/j.1524-4725.2007.34077.x.

Izikson L, Nelson JS, Anderson RR. Treatment of hyper-trophic and resistant port wine stains with a 755 nm laser: A case series of 20 patients. Lasers Surg Med 2009; 41(6): 427–432. doi: 10.1002/lsm.20793.

Ekbäck M, Molin L. Effective laser treatment in a case of lupus pernio. Acta Derm Venereol 2005; 85(6): 521–522. doi: 10.1080/00015550510027423.

Zachary CB, Rofagha R. Laser therapy. In: Bolognia JL, Jorizzo JL, Schaffer JV (editors). Dermatology. 3rd ed. London: Mosby; 2012.

Humphreys TR, Malhotra R, Scharf MJ, Marcus SM, Starkus L, et al. Treatment of superficial basal cell carcinoma and squamous cell carcinoma in situ with a high-energy pulsed carbon dioxide laser. Arch Dermatol 1998; 134(10): 1247–1252. doi: 10.1001/archderm.134.10.1247.

Trelles M, David L, Rigau J. Penetration depth of ultrap-ulsed carbon dioxide laser in human skin. Dermatol Surg 1996; 22: 863–865. doi: 10.1111/j.1524-4725.1996.tb005-89.x.

Sakamoto FH, Avram MM, Anderson RR. Lasers and other energy technologies – Principles & skin interactions. In: Bolognia JL, Jorizzo JL, Schaffer JV (editors). Dermatology. 3rd ed. London: Mosby; 2012.

Young HS, Chalmers RJ, Griffiths CE, August PJ. CO2 laser vaporization for disfiguring lupus pernio. J Cosmet Laser Ther 2002; 4(3–4): 87–90. doi: 10.1080/14764170-232113¬6255.

O'Donoghue NB, Barlow RJ. Laser remodelling of nodu-lar nasal lupus pernio. Clin Exp Dermatol 2006; 31(1): 27–29. doi: 10.1111/j.1365-2230.2005.01960.x.

Rosende L, del Pozo J, de Andrés A, Pérez Varela L. In-tense pulsed light therapy for lupus pernio (Spanish) [Tratamiento de lupus pernio con luz pulsada in-tense]. Actas Dermosifiliogr 2012; 103: 71–73.doi: 10.1016/j.adengl.2011.02.004.

Emer J, Uslu U, Waldorf H. Improvement in lupus pernio with the successive use of pulsed dye laser and nonablative fractional resurfacing. Dermatol Surg 2014; 40(2): 201–202. doi: 10.1111/dsu.12376.

Kormeili T, Neel V, Moy RL. Cutaneous sarcoidosis at sites of previous laser surgery. Cutis 2004; 73(1): 53–55.

Green JJ, Lawrence N, Heymann WR. Generalized ulcer-ative sarcoidosis induced by therapy with the flashlamp- pumped pulsed dye laser. Arch Dermatol 2001; 137(4): 507–508.

Published
2016-03-28
Section
Reviews