“We've done some work with the Lunula device (Erchonia) for nail psoriasis, with some very good success,” he says.
Specifically, Dr. Nestor has used the device to treat the nails of 40 to 50 patients, typically resulting in normal-appearing nails when they grow back. “We've used Lunula for years for onychomycosis, and it's very effective and FDA-approved for that indication. But we've found that it is extremely beneficial in psoriatic nails.”
At Medicare allowable rates of $174 to $260, adds Dr. Nestor, reimbursement for any laser treatment of psoriasis is fairly reasonable. Although one need not specify which type of laser was used, he says, it's important to report appropriately what was done in what treatment area.
“There's no magic to it — it just needs to be documented properly.”
Overall, Dr. Nestor says, phototherapy remains a very potent modality for psoriasis. “That's the key for treatment of psoriasis — it's not just about biologics. There are other modalities that work well.”
Dr. Nestor was a paid researcher in the 650 µs Nd:YAG laser study but reports no relevant financial interests.
1. Mark S Nestor MD. “Lasers and Psoriasis: The Future of Phototherapy,” South Beach Symposium. February 8, 2019.
2. Nestor MS, Fischer D, Arnold D. Randomized, investigator-blinded study to compare the efficacy and tolerance of a 650-microsecond, 1064-nm YAG laser to a 308-nm excimer laser for the treatment of mild to moderate psoriasis vulgaris. J Drugs Dermatol. 2020;19(2)176-183. Doi:10.36849/JDD.2020.4769.