Layla had been a long-term (>1 year) patient of the dermatology service for the autoimmune skin disease Pemphigus Foliaceous, of which the hallmarks are marked pain and swelling due to blistering, vesiculation, and secondary infections of the skin. Layla was on a combination of several immunosuppressive medications and chronic antibiotics but had never been in remission since her disease was diagnosed one year prior. Newly diagnosed high blood pressure and incredible liver enzyme elevations (ALP >5000) had led to discussions about euthanasia due to decreasing quality of life. The owner felt Layla did not seem comfortable or interested in her normal activities (eating, playing) as her illness progressed. Her skin lesions had begun on her face (predominantly nasal planum) and ears and had progressed to body-wide. The UTVMC Dermatology service said this was the most resistant case of P.F. they had ever seen.
Layla became a patient of the Integrative Medicine Service in Spring 2012. The owner was largely considering euthanasia but wanted to consider all options prior to that decision. A variety of options were discussed, and after meeting the service, Layla’s owner decided to put Layla on a homemade balanced diet and liver-protective supplements. Biweekly sessions were begun using the 670 nm module on the Respond Systems Luminex Ultra laser.
The first 6 sessions consisted of 6 J/cm2, CW, on lesions of the body and face. When working around the face, protective eyewear appropriate for the laser wavelength was placed on Layla; during the treatment on regions other than the face, a black cloth was held lightly over Layla’s eyes to shield them.
After the first two sessions, Layla’s owner noted improved comfort when walking due to decreased foot swelling as well as decreased pruritus and scratching. It was noted that the blisters present healed faster after laser therapy, and secondary infections were largely eliminated (based on observation and skin cytology).
After the first month of biweekly sessions, Layla began coming in once weekly for laser therapy. A repeat of bloodwork showed her liver enzymes had decreased by 50%, and her palpable hepatomegaly was visibly decreasing.
A slow wean off of some of her immunosuppressive medications was begun, and a repeated decrease in her systolic/diastolic blood pressure allowed weaning off of her anti-hypertensive medication. Monthly laser sessions have been initiated at the three-month period, and Layla will continue to be monitored, with her progress updated.
The Luminex Ultra 670 nm red laser contributed to increased skin lesion healing and enhanced patient comfort, with no side effects observed, unlike other treatment modalities. The Dermatology service was amazed that Layla was approaching remission while also reducing her immunosuppressive medications.
Laser Specifications:
Power Density : 500mW/cm2
Beam Area: 1 cm2
Energy: 6 Joules
Energy Density: J J/cm2
Treatment Time: 12 seconds
Laser Output Power: .5W