Treatment Of Porokeratosis With Erbium Laser:Case Report And Literature Review

Background:Porokeratosis,a rare cutaneous disorder of keratinization,is mainly seen on the face,neck and extremities which is clinically characterized by annular plaque with hyperke-ratotic ridge and central normal or atrophy.It is histologically characterized by cornoid lamella which is made up of parakeratotic keratinocytes extending through the stratum corneum.At present,several options have been applied to treat porokeratosis,including5-fluorouracil,liquid nitrogen freezing,carbon dioxide laser,but most of these treatments have adverse reactions,which may lead to scarring,recurrence,hyperpigmentation or hypopigmention.Porokeratosis is rarely concerned by most patients and doctors due to the lack of physical discomfort.With the increasing requirement for facial beauty,more and more patients have the high demands for treatment.Thus,there is a need to develop a new and more effective therapy to treat porokeratosis.Erbium-doped yttrium aluminum garnet(Er:YAG)laser is a new treatment approach.Comparing with other treatments,it also have relatively shorter healing time with fewer side effects.Er:YAG laser has been widely applied in seborrheic keratosis,melasma with less adverse reactions.We speculate that Er:YAG laser may be a more effective method for porokeratosis.Objection:To understand its pathogensis,clinical manifestations,treatment methods and patho-gensis.To appraise the safety and validity of Er:YAG laser for the treatment of porokera-tosis.To discover a new way to treat porokeratosis,which might increase the living quality of patients.Methods:The clinical data of one 28-year-old woman who was diagnosed with porokeratosis by pathology,and treated by Er:YAG laser,was studied and retrospectively analyzed.Er:YAG laser(2940nm)was operated at 3.75-5.00J/cm~2 with a 2-mm spot size,2.0-Hz repetition rate.The patient received treatments at 6 weeks intervals for 2 times,and the follow-up period was 12 months.Results:90%lesions subsided after final treatment.There had been no hyperpigmentation,skin scar and recurrence in the following of 12 months after treatment.Conclusions:Er:YAG laser will produce rapid heating in the superficial layers of the skin,cause minimal thermal injury,and lead to precise tissue vaporization.The side effects are few and the healing time is relatively short.We report a patient with disseminated superficial porokeratosis who was successfully treated with Er:YAG laser.Er:YAG laser may be an effective treatment for porokeratosis,but more studies are needed in the treatment of poro-keratosis.