[P055] A case of localized scleroderma treated with excimer laser

We present the case of a 19-year-old female with 10 cm x 5 cm gray to brown colored firm patch on the lower back. She was transferred to our hospital after 1-year treatment with topical steroid, tacrolimus, intralesional triamcinolone injection and phototherapy (narrow band UBV 400 mL/㎠) according to biopsy findings consistent with localized scleroderma. We initially maintained phototherapy twice per week for 2 years with topical tacrolimus. As she showed poor response, we tried treatment with 308 nm excimer laser twice per week. The lesion responded to the treatment with decrease in size and softening by 10 months. Symptomatic discomfort of tight feeling was also considerably relieved. Localized scleroderma, or morphea, is an autoimmune disease of the skin and subcutaneous tissue. The excimer laser has been tried for treatment of various dermatologic conditions. The mechanism is represented by depletion of T cells, altering apoptosis-mediating molecules and decreasing cytokine expression. We report this case to suggest the excimer laser as one of treatment options for refractory localized scleroderma.