Case Series: Successful Management of Refractory Plaque Psoriasis With Combined Laser Therapy and Topical Roflumilast in 2 Patients.

This case series describes the treatment of 2 patients with chronic plaque psoriasis refractory to conventional topical corticosteroid therapy. Both patients declined additional topical and systemic treatments and were subsequently treated monotherapy with a 1,064nm neodymium-doped yttrium aluminium garnet laser (Aerolase Neo Elite; Aerolase, Tarrytown, New York). When pruritus returned and worsened, both subjects trialed roflumilast cream 0.3% as combination therapy alongside the ongoing laser treatments. The addition of roflumilast cream greatly improved each of their symptoms, ultimately leading to resolution of pruritus and significant improvement of plaque size and texture.