Medical indications for laser therapy in dermatology

Background: Laser therapy in dermatology is often associated with cosmetic procedures. However, nowadays, because of novel technological developments, lasertherapy has become an optional treatment modality for many different, also congenital, dermatological diseases. For a few of these dermatological diseases, with great impact on the quality of life of affected patients, until to date no or little therapeutical options were available. For example because of the size of the affected area or due to resistance to conventional therapies. Laser therapy is based on selective heating and destruction of tissue components such as pigments, bloodvessels, hairs or the entire epidermis. In this clinical case description we discuss three patients with different dermatological diseases, treated with ablative laser therapy, which had a big improvement of their skin condition as well as of their quality of life. Case description: Three cases with different dermatological conditions, that were resistent to conventional therapies are presented. The first case is a young man with multiple angiofibroma's in the face as part of the Tuberous Sclerosis Complex (TSC). This young man seeked medical treatment for his gradually progressive skin lesions , which could not be improved by other therapies. A 64 year-old man with a large tumorous nose was treated with CO2 ablative lasertherapy because of granuloma faciale. He underwent and failed multiple conventional treatments before, such as antibiotics, intralesional injection of corticosteroids and non-ablative laser therapy. Finally a woman with neurofibromatosis type 1 of the face was treated with full-face CO2 ablative laser therapy. She had extensive neurofibromas on her body and in her face. Especially those in the face were troublesome for our patient and had a great negative impact on her quality of life. Surgical excision was not an option because of the extensiveness of the neurofibromas. In the end, our patient was succesfully treated with ablative laser therapy. Conclusion: We would like to show specialists, general practitioners, health insurers and patients the possibile therapeutical options of lasertherapy for therapy resistent dermatological diseases. Laser therapy not only improved the primary skin lesions of presented patients, but also greatly improved their quality of life.