Musculoskeletal Research Group, School of Translational Medicine Dermatology Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK.
Br J Dermatol. 2012 Sep;167(3):563-9. doi: 10.1111/j.1365-2133.2012.11019.x. Epub 2012 Jul 25.
Telangiectases represent microvascular changes inherent in the systemic sclerosis (SSc) disease process. Intense pulsed light (IPL) is an effective treatment for non-SSc-related cutaneous telangiectases.
This pilot study aimed to examine the efficacy, safety and tolerability of IPL treatment in an open study of patients with SSc.
Patients underwent three treatments of IPL at monthly intervals and attended follow-up examinations at 1, 6 and 12 months after final treatment. Photographs, laser Doppler imaging (LDI) and thermography were used to measure changes at each visit.
Seventeen patients completed the study. Photographs were graded (compared with baseline) as: at 1-month follow-up, four 'no change', four 'improved' and eight 'much improved'; at 6-month follow-up, four 'no change', eight 'improved'; and four 'much improved'; and at 12-month follow-up (eight images were available), three 'no change', two 'improved' and three 'much improved'. Perfusion as measured by LDI (perfusion units) was significantly reduced, compared with baseline [median 2·66, interquartile range (1·78-3·93)], at 1 month [1·70 (1·07-2·55), P = 0·006] and 6 months [2·05 (1·42-2·36), P = 0·008] post-treatment, but not at 12 months [1·61 (1·14-3·22), P =0·088]. No differences were found in skin temperature between baseline and follow-up visits.
In this pilot study (the first of IPL treatment for SSc-related telangiectases) most patients improved after IPL treatment. However, the degree of improvement was not maintained in all patients at 6-12 months, suggesting that further treatments may be necessary. Longer term studies of this novel treatment approach are now required.
毛细血管扩张症代表系统性硬化症（SSc）疾病过程中的微血管变化。强脉冲光（IPL）是治疗非 SSc 相关皮肤毛细血管扩张症的有效方法。
本研究旨在通过开放研究评估 IPL 治疗 SSc 患者的疗效、安全性和耐受性。
患者每月接受三次 IPL 治疗，并在末次治疗后 1、6 和 12 个月进行随访检查。每次就诊时均使用照片、激光多普勒成像（LDI）和热成像来评估变化。
17 例患者完成了研究。根据照片与基线相比的评分：在 1 个月的随访时，4 例为“无变化”，4 例为“改善”，8 例为“明显改善”；在 6 个月的随访时，4 例为“无变化”，8 例为“改善”，4 例为“明显改善”；在 12 个月的随访时（有 8 张图像），3 例为“无变化”，2 例为“改善”，3 例为“明显改善”。与基线相比，LDI（灌注单位）测量的灌注显著减少[中位数 2.66，四分位距（1.78-3.93）]，在治疗后 1 个月[1.70（1.07-2.55），P=0.006]和 6 个月[2.05（1.42-2.36），P=0.008]时，但在 12 个月时[1.61（1.14-3.22），P=0.088]没有差异。基线和随访时的皮肤温度无差异。
在这项 IPL 治疗 SSc 相关毛细血管扩张症的初步研究中，大多数患者在 IPL 治疗后有所改善。然而，并非所有患者在 6-12 个月时都能保持改善程度，这表明可能需要进一步治疗。现在需要进行这项新治疗方法的长期研究。
