Molecular Changes Induced by Carbon Dioxide Laser in Hailey-Hailey Disease: A Potential Mechanism Underlying...

Hailey-Hailey disease (HHD) is a rare genodermatosis caused by mutations in the ATP2C1 gene that codes for SPCA1, a calcium transporter in the epidermis. HHD impairs quality of life, and no curative treatment exists.

To confirm the efficacy and safety of CO₂ laser in HHD, we conducted a randomized, prospective, controlled study that included 10 patients with histologically confirmed HHD. A 4-mm punch biopsy was taken from unaffected skin and the laser-treated area before treatment. CO₂ laser treatment was performed under sedation, and after 6 months, new biopsies were taken at the same sites. Samples were used to extract RNA and analyze potential changes in gene expression.

Laser treatment provided a significant reduction in the lesioned area (p < 0.002). Gene expression analysis revealed reduced ATP2C1 expression in lesional skin and high expression of genes related to keratinocyte proliferation and IL-17-dependent inflammation. Interestingly, in affected skin after laser treatment, there was an enhancement of ATP2C1 with a reduced expression of genes related to keratinocyte proliferation and IL-17-dependent inflammation.

CO₂ laser is safe and effective in HHD. A plausible explanation could be molecular changes after treatment, especially ATP2C1 enhancement and IL-17-dependent inflammation decreased.