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. 2015 Apr 10;1(2):95-98.
doi: 10.1016/j.ijwd.2015.01.006. eCollection 2015 Jun.

Excimer laser therapy and narrowband ultraviolet B therapy for exfoliative cheilitis

Bhavnit K Bhatia  1 , Brooks A Bahr  2 , Jenny E Murase  3   4
Affiliations

Excimer laser therapy and narrowband ultraviolet B therapy for exfoliative cheilitis

Bhavnit K Bhatia et al. Int J Womens Dermatol. .

Abstract

Background: Exfoliative cheilitis is a condition of unknown etiology characterized by hyperkeratosis and scaling of vermilion epithelium with cyclic desquamation. It remains largely refractory to treatment, including corticosteroid therapy, antibiotics, antifungals, and immunosuppressants.

Objective: We sought to evaluate the safety and efficacy of excimer laser therapy and narrowband ultraviolet B therapy in female patients with refractory exfoliative cheilitis.

Methods: We reviewed the medical records of two female patients who had been treated unsuccessfully for exfoliative cheilitis. We implemented excimer laser therapy, followed by hand-held narrowband UVB treatments for maintenance therapy, and followed them for clinical improvement and adverse effects.

Results: Both patients experienced significant clinical improvement with minimal adverse effects with excimer laser therapy 600-700 mJ/cm2 twice weekly for several months. The most common adverse effects were bleeding and burning, which occurred at higher doses. The hand-held narrowband UVB unit was also an effective maintenance tool.

Limitations: Limitations include small sample size and lack of standardization of starting dose and dose increments.

Conclusion: Excimer laser therapy is a well-tolerated and effective treatment for refractory exfoliative cheilitis with twice weekly laser treatments of up to 700 mJ/cm2. Transitioning to the hand-held narrowband UVB device was also an effective maintenance strategy.

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Figures

Fig. 1
Fig. 1
A, Exfoliative cheilitis. Patient 1 before beginning excimer laser therapy, with thick scaling and hyperkeratosis. B, Exfoliative cheilitis. Patient 1 showing significant improvement in scaling and dryness after completing 8 months of excimer therapy.
Fig. 2
Fig. 2
A, Exfoliative cheilitis. Patient 2 before beginning excimer therapy, demonstrating initial scaling and hypopigmentation. B, Exfoliative cheilitis. Patient 2 after 3 months of excimer laser therapy and 6 months of home narrowband UVB therapy, with minimal scaling and significant improvement of hypopigmentation.
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