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Fractional Carbon Dioxide Laser for Lichen Simplex Chronicus: A Randomized Controlled Trial
Samia Esmat1, Iman Sany1, Lobna Alieldin1
1Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Background:
Lichen simplex chronicus (LSC) is a common itchy dermatosis. Topical steroids are usually used as first-line therapy. Fractional carbon dioxide (CO 2 ) laser has shown efficacy in reduction of pruritus in different itchy dermatoses. However, controlled studies evaluating its efficacy in LSC are scarce in the literature.
Objective:
The authors aimed to compare the efficacy of fractional CO 2 laser either alone or combined with topical corticosteroid to topical corticosteroid alone in treatment of LSC.
Patients And Methods:
Sixty LSC patients were randomized into 3 groups receiving fractional CO 2 laser, topical corticosteroid, or both, for 3 months. Disease severity was assessed before and after treatment, using patient-reported outcomes, namely pruritus severity scale and visual analog scale (VAS), and physician-reported outcomes in the form of erythema, lichenification, scaling and excoriation scores and Investigator's Global Assessment (IGA).
Results:
Treatment with combined fractional CO 2 laser and topical corticosteroid was associated with the highest incidence of achieving IGA score of 0 or 1 and VAS 50%, followed by laser and then topical corticosteroid arms (93.3%, 66.7%, and 50%, p = .016 and 100%, 86.7%, and 66.7%, p = .028, respectively).
Conclusion:
Fractional CO 2 laser is an effective tool for treatment of LSC. Combination with topical corticosteroids can improve the outcome.
