Table 2.

Treatment protocol.

First session of CO2 laser in super-pulsed mode, with a focused beam of 0.1–0.2 mm diameter, power 0.3–0.8 W, fre-quency 10 Hz, with the intent to remove the superficial layer of the epidermis, exposing the superficial dermis but without causing bleeding.

Right after CO2 laser, a second session with long-pulsed Nd:YAG laser for lesions interesting the palmoplantar region (90–120 J/cm2, 5 mm spot size, slightly defocused, double pulse 5–15 ms with a 10 ms interval performing multiple passes), and with a 595 nm Dye laser for all other regions (10 mm size spot, fluence 9–10 J/cm2, and frequency 0.5/s, per-forming multiple passes) was performed on the treated spot, in order to reduce the vascularization to the treated area.

After the combined treatment, topical fusidic acid was applied to the lesion twice a day for one week.

From the second week, a 20% salicylic acid cream in the evening and 40% urea in the morning were applied for the other three weeks up to clinical follow-up.

A first clinical follow-up at one month evaluated lesion disappearance.

A second clinical follow up at four months evaluated relapses.