Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (N.I.L.E.S.), Cairo University, Giza 12316, Egypt.
Am J Clin Dermatol. 2013 Jun;14(3):235-41. doi: 10.1007/s40257-013-0027-7.
Localized scleroderma (morphea) is characterized by hardening and thickening of the dermis due to excessive collagen deposition. A decreased number of CD34+ cells and an increased number of Factor XIIIa+ cells are seen in the affected skin. The flashlamp pulsed dye laser (FLPDL) has been used in the treatment of localized morphea with promising results.
The purpose of this study was to evaluate the therapeutic effectiveness of the pulsed dye laser in localized scleroderma and to assess its effect on CD34+ cells, Factor XIIIa+ cells, and blood vessels.
Thirty patients with plaque morphea were treated with a FLPDL (585 nm wavelength, 450 μs pulse duration). Fluence ranged from 7.5 to 8.5 J/cm(2). Sessions were performed biweekly for a maximum of 6 months. Clinical, histopathologic, and immunohistochemical assessments were performed.
Patients showed varying degrees of improvement of indurated skin. There was no worsening or further improvement at the treated sites during the follow-up assessments at 3, 6, and 12 months. An increased number of CD34+ cells were found in both the upper and the lower dermis, and a decreased number of Factor XIIIa+ cells were found in the lower dermis.
The FLPDL is effective in the treatment of morphea, as confirmed by the changes in the pathologic tissue and levels of CD34+ and Factor XIIIa+ cells.
局限性硬皮病（硬斑病）的特征是真皮由于胶原过度沉积而变硬变厚。受影响的皮肤中可见 CD34+细胞数量减少，Factor XIIIa+细胞数量增加。闪光灯脉冲染料激光（FLPDL）已用于治疗局限性硬斑病，取得了良好的效果。
本研究旨在评估脉冲染料激光治疗局限性硬皮病的疗效，并评估其对 CD34+细胞、Factor XIIIa+细胞和血管的影响。
30 例斑块硬斑病患者接受 FLPDL（585nm 波长，450μs 脉冲持续时间）治疗。能量密度范围为 7.5 至 8.5 J/cm2。每两周进行一次治疗，最多进行 6 个月。进行临床、组织病理学和免疫组织化学评估。
患者的硬化皮肤有不同程度的改善。在 3、6 和 12 个月的随访评估中，治疗部位没有恶化或进一步改善。在上皮和真皮下部均发现 CD34+细胞数量增加，在真皮下部发现 Factor XIIIa+细胞数量减少。
FLPDL 治疗硬斑病有效，这可以通过病理组织以及 CD34+和 Factor XIIIa+细胞水平的变化得到证实。
