34.    308-nm excimer laser treatment of lichen planopilaris of the scalp. 
Bettina Prinz Vavricka, Susanne Haug, Ioannis Eliades, Ralph Trüeb,  Department of Dermatology, University Hospital Zurich, Switzerland.

Introduction: Lichen planopilaris (LPP) is a chronic inflammatory disorder eventually leading to permanent scarring alopecia. Therapy of LPP is difficult, though corticosteroids, antimalarials, retinoids, and immunosuppressive agents have been reported with variable success. Photochemotherapy with topical psoralen and UV-A represents a treatment with comparable results, less toxicity, but it is costly, time consuming and messy. The handheld XTRAC excimer laser (monochromatic 308nm UVB-light), allows selective treatment of lesional skin with higher single doses, fewer treatments, and lesser cumulative doses. It has proven to be effective in other chronic inflammatory skin disorders. The aim of the study was to evaluate the efficacy of XTRAC excimer laser for treatment of LPP and LPP variants (frontal fibrosing alopecia). Methods: Subjects were scheduled to receive 8-24 treatments. 13 patients (11 female, 2 male) with biopsy-proven LPP, unresponsive to conventional therapies, were included. Laser radiation was delivered twice weekly to one half of the scalp, the untreated served as control. A treatment protocol analogous to that for psoriasis was chosen. The scalp area was assessed weekly, with respect to erythema, infiltration, hyperkeratosis, hair growth, and pigmentation. Patients were asked to rate the severity of their baseline symptoms itch, pain, and hair loss. Results: The patients received a mean dosis of 4538.5 mJ/cm2 after an average of 10 treatments. In 6 patients there was no difference between both sides. Four patients initially showed improvement of erythema, but after 4 weeks of treatment there was no difference. One patient had sustained improvement of pruritus and erythema. Two patients had increased hair growth, one with repigmentation of hair. New lesions appeared to be more responsive than old lesions. Conclusion: We conclude that the XTRAC 308-nm excimer laser represents a potential treatment modality for LPP. Probably, patient selection and treatment protocol need to be improved for superior results, since only 3 of 13 patients had a benefit.