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Correspondence |

Fractional Photothermolysis: A Novel Treatment for Disseminated Superficial Actinic Porokeratosis

Brenda Chrastil, MD; Adrienne S. Glaich, MD; Leonard H. Goldberg, MD, FRCP; Paul M. Friedman, MD
Arch Dermatol. 2007;143(11):1447-1462. doi:10.1001/archderm.143.11.1450.
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Disseminated superficial actinic porokeratosis (DSAP) occurs diffusely in sun-exposed areas, notably the legs and forearms. The exposed nature of the lesions can cause emotional distress among patients. Additionally, these lesions present a risk of transformation into invasive squamous cell carcinoma. Treatments for DSAP have had mixed results, especially for extensive lesions. We report 2 cases of DSAP responding to treatment with fractional photothermolysis.

Manstein  DHerron  GSSink  RKTanner  HAnderson  RR Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004;34 (5) 426- 438
PubMed Link to Article[[XSLOpenURL/10.1002/(ISSN)1096-9101]]
Geronemus  RG Fractional photothermolysis: current and future applications. Lasers Surg Med 2006;38 (3) 169- 176
PubMed Link to Article[[XSLOpenURL/10.1002/(ISSN)1096-9101]]
Behroozan  DSGoldberg  LHGlaich  ASDai  TFriedman  PM Fractional photothermolysis for treatment of poikiloderma of Civatte. Dermatol Surg 2006;32 (2) 298- 301
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Figure 1.

Areas of disseminated superficial actinic porokeratosis (ovals) during the fractional photothermolysis treatment course on the thigh of patient 1. A, Red, scaly, slightly elevated papules and plaques at baseline. B, After 3 treatments to the entire thigh, a moderate to marked flattening and fading of the lesions has occurred. (Note the bruise on the medial knee and thigh.) These results were maintained for 8 months. C, After 6 treatments to the anterior surface of the thigh, the lesions have improved further. The patient reported resolution of pruritus and a marked improvement of skin texture. These results were maintained for 1 year after the last treatment. There is a bruise on the lateral thigh.

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Figure 2.

Area of disseminated superficial actinic porokeratosis (DSAP) (rectangle) and DSAP lesion of interest (arrow) during the fractional photothermolysis treatment course on the lower leg of patient 1. A, Baseline. B, After 3 treatments to the entire leg. C, After 6 treatments to the leg, a marked reduction in the number, color, and scaliness of the lesions is evident. Note the fading and flattening of the lesion demarcated by the arrow. Clinically, the smoothness of the skin increased. Note the decrease in the number of lesions within the marked rectangle as well as the fading and flattening of the large lesions within the rectangle.

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