Aesthetic Medicine
Aesthetic Medicine


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Skin deep

There are many different types of autoimmune skin diseases and they are caused by the immune system attacking healthy skin cells. Normally, white blood cells produce antibodies that attack harmful cells as they appear in the body. The opposite happens in autoimmune diseases. Antibodies attack healthy tissues instead of the harmful ones.

This causes many different symptoms that affect the joints, internal organs and skin. The most common autoimmune skin conditions are psoriasis, vitiligo, alopecia areata and atopic dermatitis.

Psoriasis is defined as epidermal thickening as a result of keratinocytes proliferation. The epidermal turnover is accelerated due to the releasing of multiple cytokines by immune cells, especially T lymphocytes. Both environmental and genetic factors interfere in the pathogenesis of psoriasis and these cause a cascade of inflammatory and immune responses which lead to the formation of psoriatic plaques which can severely impact quality of life. Corticosteroids and immunosuppressive drugs are commonly prescribed to treat psoriasis to reduce the effects of an overactive immune system, but cannot be used for long periods.

Vitiligo is an autoimmune disease that results in the destruction of melanocytes in the skin, leading to depigmentation. The disease affects one percent of the population worldwide and is especially pronounced in darker skin tones. Current treatment regimes include prolonged use of topical steroids, which rarely achieve greater that 50% repigmentation and require daily applications. Side effects can include thinning of the skin.

Light therapy has been used for many years to treat autoimmune skin conditions. These include oral or topical psoralen plus ultraviolet A eradication ( PUVA) and narrowband ultraviolet B eradication (NB- UVB), and excimer laser. With PUVA and NB-UVB therapy, it may take a year or longer to achieve results, and in some cases of vitiligo, repigmentation was less than 50% by 12 weeks.1 NB-UVB is often administered to the full body treating unaffected skin as well as the target area. Excessive exposure to UVB on normal skin can damage the outer layers, causing premature ageing and influencing the likelihood of developing skin cancer.

Exciplex is a new device using a powerful 308nm excimer lamp in a handheld device that can specifically target and deliver UVB light to the lesion, avoiding the surrounding unaffected skin. The treatment implies apoptosis of T lymphocytes and immunosuppressive effects, resulting in clinical improvement of immune skin diseases. The Exciplex 308nm has proven highly effective in treating vitiligo ,psoriasis, alopecia areata and atopic dermatitis. The device is backed by 180 clinical studies showing impressive safety and efficacy.2

Light is delivered with great precision in varying spot sizes and treatment is pain-free. Treatment takes just a few minutes, meaning that a high volume of patients can be be treated in clinic. Protocol is typically two times per week for ten weeks.

REFERENCES

1. Bae, Jung Min et al. “Phototherapy for Vitiligo: A Systematic Review and Meta-analysis.” JAMA dermatology vol. 153,7 (2017): 666-674. doi:10.1001/ jamadermatol.2017.0002

2. Information from Exciplex manufacturer Clarteis

For more information visit cosmeditech.com

This article appears in the October 2021 Issue of Aesthetic Medicine

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This article appears in the October 2021 Issue of Aesthetic Medicine