Excimer laser therapy and narrowband ultraviolet B therapy for exfoliative cheilitis()()

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/cm(2) 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/cm(2). Transitioning to the hand-held narrowband UVB device was also an effective maintenance strategy.