Psoriasis Vulgaris
Conditions
Brief summary
The researchers investigate the effect of a treatment with selective photothermolysis using a 595 nm pulsed dye laser on the blood vessel density and the nerve fibre density of a psoriatic lesion. By comparing tissue samples collected before and after two treatments, the researchers determine the relative effect of laser therapy on the (hyper)innervation of psoriatic skin.
Detailed description
Vascular laser therapy for psoriasis seems to achieve a remarkably long treatment-free duration of remission. But why would sub-second heating of the blood vessels of the skin result in a year-long resolution of an infamously stubborn condition? Unraveling the mechanism of action of laser therapy would not only allow for the improvement of existing laser therapy protocols but also, could open the door to a whole new range of interventions offering quasi-permanent solutions for patients. There is a high need for such enduring therapies: Psoriasis is both, a common and a costly skin condition. It affects between 1% and 9% of the population and has a very severe impact on the quality of life of the patient. It's chronic character implies lifelong treatment, and the associated risks and effort This project aims to assess the effect of laser therapy on the blood vessels and (peripheral) innervation of psoriasis plaques. The primary objective is to quantify the regression and recovery of nerves compared to blood vessels. The researchers hypothesize that the recovery of nerves after Selective Photo Thermolysis (SPT) is decreased compared to the recovery of blood vessels.
Interventions
DEVICE595 nm Pulsed dye laser (Candela V-beam perfecta)
595 nm pulsed dye laser therapy. 2 treatments Fluence \ 6 - 9 J/cm\^2 Pulse duration \ 0.45 - 3.0 ms 33% overlap.
Sponsors
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Nick van der Beek
Study design
Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Masking description
tissue samples are described using random pre-assigned codes.
Intervention model description
single blinded intra-patient comparison
Eligibility
Sex/Gender
ALL
Age
18 Years to 69 Years
Healthy volunteers
No
Inclusion criteria
* 18 - 69 years of age * Psoriasis vulgaris * Skin type I - III * Minimal surface of lesion of 3 cm2 * Contralateral psoriasis vulgaris lesions located on chest, back, or upper legs
Exclusion criteria
A potential subject who meets any of the following criteria will be excluded from participation in this study if: * The participant uses other treatments (than laser therapy) during the study or two weeks before the start of the study that are known to affect psoriasis * The participant suffers from any known neurological, vascular, or immunological condition other than psoriasis. * The participant is allergic to lidocaine
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recovery ration | 6 months. | Relative change in the ratio of the linear nerve density and linear blood vessel density. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Recovery ratio vs lymphocyte infiltration | 6 months | Correlation between change in the ratio of the linear nerve density and linear blood vessel density versus change in number of infiltrating lymphocytes |
| Clinical improvement | 6 months | Change in severity determined using a visual-analogue scale. |
Countries
Netherlands
Outcome results
None listed