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Pointing light at soft tissue: clinical applications 69

Table 7.3 Recommended parameters for dermatitis.
Example Dose (J/cm ) Power (W) Power density (W/cm )
2
2
Acute superficial Hot spot 2–5 1–4 0.1–0.5
Chronic superficial Chronic dermatitis 4–15 2–4 0.3–0.6

pyoderma (and usually both). Traditional treatment compared to what you use in acute cases, i.e. use 4–8 J/
2
includes clipping the area, using topical antiseptics and cm and 2–4 W. Start with the lower settings but con-
a variety of topical and/or systemic corticosteroids and sider increasing values if after 2–3 sessions you don’t
antimicrobials. The systemic use of these medications see a significant change. Chronic steroid therapy can
can (and should) be avoided in most cases, and LT is delay the response, but in most cases you will notice
a very useful adjunct that quickly decreases inflamma- improvement in both lesions and patient comfort (Fig.
tion and discomfort and helps with the skin infection 7.8).
and regeneration.
Rinse off topical treatments before LT. Use 1–3W 7.4.2 Pododermatitis
2
and 3–5 J/cm , but keep a low power density in the
most acute phase and inflamed cases. Treat daily for This is a general term that comprises a number of
2–4 days, then gradually decrease frequency of treat- presentations of local, dermatological, and systemic
ment (Table 7.3). conditions leading to inflammation of the skin in
Chronic dermatitis can be more challenging to treat the paws, with or without concurrent infection (Fig.
due to the permanent tissue changes we encounter. 7.9). You will probably have been faced with frus-
Nevertheless, LT can be a very useful adjunct – and trating cases, and LT does help, but before you run
sometimes substitute – to traditional pharmacologi- to get your laser, please work a diagnosis: fungal,
cal treatment. Consider increasing dose and power bacterial, and parasitic infections are on the list,

(a) (b) (c) (d)

Figure 7.8 (a–d) This 11-year-old male castrated (MC) Pit Bull had been on different courses of steroids and antibiotics for over
9 years. He had a deep pyoderma and was referred for LT due to gastrointestinal side effects of the medication. The pictures
show the progression over 5 weeks and 14 treatments. All medications were discontinued when LT started (progressively in the
2
2
case of steroids). By the middle of the treatment, dose was increased from the initial 4 J/cm to 17 J/cm . Average power was
2
initially 3 W, and later increased to 4 W. Power density was kept around 0.5 W/cm . The whole circumference of the hindlimb
was treated, from the proximal tibia to the foot.

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