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光生物调节疗法:系统性硬化症皮肤溃疡治疗的新希望

Photobiomodulation Therapy: A New Light in the Treatment of Systemic Sclerosis Skin Ulcers.

作者信息

Spinella Amelia, de Pinto Marco, Galluzzo Claudio, Testoni Sofia, Macripò Pierluca, Lumetti Federica, Parenti Luca, Magnani Luca, Sandri Gilda, Bajocchi Gianluigi, Starnoni Marta, De Santis Giorgio, Salvarani Carlo, Giuggioli Dilia

机构信息

Scleroderma Unit, Chair and Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico of Modena, Policlinico di Modena, Via del Pozzo, 71, 41125, Modena, Italy.

Unit of Rheumatology, AUSL-IRCCS of Reggio Emilia, Reggio Emilia, Italy.

出版信息

Rheumatol Ther. 2022 Jun;9(3):891-905. doi: 10.1007/s40744-022-00438-9. Epub 2022 Mar 25.

Abstract

INTRODUCTION

Skin ulcers (SU) represent one of the most frequent manifestations of systemic sclerosis (SSc), occurring in almost 50% of scleroderma patients. SSc-SU are often particularly difficult to treat with conventional systemic and local therapies. In this study, a preliminary evaluation of the role and effectiveness of blue light photobiomodulation (PBM) therapy with EmoLED in the treatment of scleroderma skin ulcers (SSc-SU) was performed.

METHODS

We retrospectively analyzed 12 consecutive SSc patients with a total of 15 SU on finger hands. All patients were treated with adequate systemic therapy and local treatment for SU; after a standard skin ulcer bed preparation with debridement of all lesions, EmoLED was performed. All patients were locally treated every week during 2 months of follow-up; SU data were collected after 4 weeks (T4) and 8 weeks (T8). Eight SSc patients with comparable SU were also evaluated as controls.

RESULTS

The application of EmoLED in addition to debridement apparently produced faster healing of SU. Complete healing of SU was recorded in 41.6% cases during EmoLED treatment. Significant improvements in SU area, length, and width, wound bed, and related pain were observed in EmoLED patients from T0 to T8. Control subjects treated with standard systemic/local therapies merely showed an amelioration of SU area and width at the end of the follow-up. No procedural or post-procedural adverse events were reported.

CONCLUSIONS

The positive clinical results and the absence of side effects suggest that EmoLED could be a promising tool in the management of SSc-SU, with an interesting role to play in the healing process in addition to conventional systemic and local treatments.

摘要

引言

皮肤溃疡(SU)是系统性硬化症(SSc)最常见的表现之一,几乎50%的硬皮病患者会出现。SSc相关的SU通常特别难以用传统的全身和局部疗法治疗。在本研究中,对采用EmoLED的蓝光光生物调节(PBM)疗法在治疗硬皮病皮肤溃疡(SSc-SU)中的作用和有效性进行了初步评估。

方法

我们回顾性分析了12例连续性SSc患者,其手指上共有15处SU。所有患者均接受了针对SU的充分全身治疗和局部治疗;在对所有病变进行清创的标准皮肤溃疡创面准备后,采用EmoLED进行治疗。在2个月的随访期间,所有患者每周接受一次局部治疗;在4周(T4)和8周(T8)后收集SU数据。另外8例具有可比性SU的SSc患者也作为对照进行评估。

结果

除清创外,应用EmoLED明显使SU愈合加快。在EmoLED治疗期间,41.6%的病例记录到SU完全愈合。从T0到T8,接受EmoLED治疗的患者在SU面积、长度、宽度、创面及相关疼痛方面有显著改善。接受标准全身/局部疗法治疗的对照受试者在随访结束时仅显示SU面积和宽度有所改善。未报告操作过程中或操作后的不良事件。

结论

积极的临床结果和无副作用表明,EmoLED可能是管理SSc-SU的一种有前景的工具,除了传统的全身和局部治疗外,在愈合过程中可发挥有趣的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeb4/9127012/11d855f969b5/40744_2022_438_Fig1_HTML.jpg

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