PMID- 25372313 OWN - NLM STAT- MEDLINE DCOM- 20150421 LR - 20160524 IS - 2168-6084 (Electronic) IS - 2168-6068 (Linking) VI - 151 IP - 2 DP - 2015 Feb TI - Treatment of keratosis pilaris with 810-nm diode laser: a randomized clinical trial. PG - 187-91 LID - 10.1001/jamadermatol.2014.2211 [doi] AB - IMPORTANCE: Keratosis pilaris (KP) is a common skin disorder of follicular prominence and erythema that typically affects the proximal extremities, can be disfiguring, and is often resistant to treatment. Shorter-wavelength vascular lasers have been used to reduce the associated erythema but not the textural irregularity. OBJECTIVE: To determine whether the longer-wavelength 810-nm diode laser may be effective for treatment of KP, particularly the associated skin roughness/bumpiness and textural irregularity. DESIGN, SETTING, AND PARTICIPANTS: We performed a split-body, rater-blinded, parallel-group, balanced (1:1), placebo-controlled randomized clinical trial at a dermatology outpatient practice of an urban academic medical center from March 1 to October 1, 2011. We included all patients diagnosed as having KP on both arms and Fitzpatrick skin types I through III. Of the 26 patients who underwent screening, 23 met our enrollment criteria. Of these, 18 patients completed the study, 3 were lost to or unavailable for follow-up, and 2 withdrew owing to inflammatory hyperpigmentation after the laser treatment. INTERVENTIONS: Patients were randomized to receive laser treatment on the right or left arm. Each patient received treatment with the 810-nm pulsed diode laser to the arm randomized to be the treatment site. Treatments were repeated twice, for a total of 3 treatment visits spaced 4 to 5 weeks apart. MAIN OUTCOMES AND MEASURES: The primary outcome measure was the difference in disease severity score, including redness and roughness/bumpiness, with each graded on a scale of 0 (least severe) to 3 (most severe), between the treated and control sites. Two blinded dermatologists rated the sites at 12 weeks after the initial visit. RESULTS: At follow-up, the median redness score reported by the 2 blinded raters for the treatment and control sides was 2.0 (interquartile range [IQR], 1-2; P = .11). The median roughness/bumpiness score was 1.0 (IQR, 1-2) for the treatment sides and 2.0 (IQR, 1-2) for the control sides, a difference of 1 (P = .004). The median overall score combining erythema and roughness/bumpiness was 3.0 (IQR, 2-4) for the treatment sides and 4.0 (IQR, 3-5) for the control sides, a difference of 1 (P = .005). CONCLUSIONS AND RELEVANCE: Three treatments with the 810-nm diode laser may induce significant improvements in skin texture and roughness/bumpiness in KP patients with Fitzpatrick skin types I through III, but baseline erythema is not improved. Complete treatment of erythema and texture in KP may require diode laser treatment combined with other laser or medical modalities that address redness. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01281644. FAU - Ibrahim, Omer AU - Ibrahim O AD - Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio. FAU - Khan, Misbah AU - Khan M AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Bolotin, Diana AU - Bolotin D AD - Section of Dermatology, University of Chicago, Chicago, Illinois. FAU - Dubina, Meghan AU - Dubina M AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Nodzenski, Michael AU - Nodzenski M AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Disphanurat, Wareeporn AU - Disphanurat W AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Kakar, Rohit AU - Kakar R AD - Department of Dermatology, Washington Hospital Center, Georgetown University, Washington, DC. FAU - Yoo, Simon AU - Yoo S AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Whiting, Dennis AU - Whiting D AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - West, Dennis P AU - West DP AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Poon, Emily AU - Poon E AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. FAU - Veledar, Emir AU - Veledar E AD - Department of Medicine, Emory University School of Medicine, Atlanta, Georgia6Department of Medicine, Baptist Health South Florida, Miami. FAU - Alam, Murad AU - Alam M AD - Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois7Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois8Department of Surgery, Feinberg School of Medicine, No. LA - eng SI - ClinicalTrials.gov/NCT01281644 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Dermatol JT - JAMA dermatology JID - 101589530 RN - Burnett Schwartz Berberian syndrome SB - IM MH - Abnormalities, Multiple/*radiotherapy MH - Adolescent MH - Adult MH - Aged MH - Darier Disease/*radiotherapy MH - Equipment Design MH - Eyebrows/*abnormalities MH - Female MH - Follow-Up Studies MH - Humans MH - Lasers, Solid-State/*therapeutic use MH - Low-Level Light Therapy/*methods MH - Male MH - Middle Aged MH - Retrospective Studies MH - Single-Blind Method MH - Treatment Outcome MH - Young Adult EDAT- 2014/11/06 06:00 MHDA- 2015/04/22 06:00 CRDT- 2014/11/06 06:00 PHST- 2014/11/06 06:00 [entrez] PHST- 2014/11/06 06:00 [pubmed] PHST- 2015/04/22 06:00 [medline] AID - 1922024 [pii] AID - 10.1001/jamadermatol.2014.2211 [doi] PST - ppublish SO - JAMA Dermatol. 2015 Feb;151(2):187-91. doi: 10.1001/jamadermatol.2014.2211.