Hailey-Hailey disease is due to abnormal adhesion of skin cells. It leads to blistering and plaques mainly in the folds of the skin. Present therapies, including topical steroids and other drugs, are often incomplete treatments. Recent investigations have evaluated ablative Er lasers as a novel therapy for HHD. This study was intended to evaluate the remission efficacy of Er-laser therapy on HHD plaques and improvements in QoL following the treatment.
Eight HHD patients received a total of 77 erosive plaques in a single Er laser treatment. Clinical responses of plaques were monitored during a median follow-up of 38 months after treatment, at baseline, six weeks post-treatment, and three years later. Quality of life was assessed using Skindex-29 and DLQI (Dermatology Life Quality Index) questionnaires. Structural changes were assessed by the skin biopsies pre- and post-treatment, compared with that of clinically unaffected skin and healthy controls in terms of intercellular spacing, desmosome count, and keratin filament configuration.
This research study established excellent rates of remission and significant quality-of-life improvement in patients as follows:
• Treated plaques from 97.4% (75 of 77) showed complete remission after a median follow-up of 38 months, suggesting a likelihood for long-term resolution following a single session of Er laser treatment.
• Both Skindex-29 and DLQI scores improved dramatically and the patients have reduced symptom burden and increased capabilities for daily activities.
• Posttreatment biopsies revealed normalization of the skin structure, including increased desmosomes, reduced intercellular distance, and restoration of keratin filament organization to close to that seen in healthy skin.
• The treated skin contained a much fewer number of abnormalities than was observed in untreated HHD skin samples and closely resembled samples of healthy controls .
Er:YAG laser treatment provides significant and long-lasting remission for Hailey–Hailey disease and significantly improves the patient's quality of life. It supports the role of ablative laser treatment in a more vital role in managing this challenging condition.
Reference:
Debeuf, M.-E. P. H., Knoops, K., López-Iglesias, C., Lookermans, E., Nelemans, P. J., Abdul Hamid, M., van Geel, M., Gostynski, A. H., Steijlen, P. M., Bolling, M. C., & Verstraeten, V. L. R. M. (2024). Long‐term remission of Hailey–Hailey disease by Er:YAG ablative laser therapy. Journal of the European Academy of Dermatology and Venereology: JEADV. https://doi.org/10.1111/jdv.20351
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