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25-03-2022 | Systemic sclerosis | Adis Journal Club | Article

Rheumatology and Therapy

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

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

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.

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Key Summary Points

Skin ulcers represent one of the most frequent manifestations of systemic sclerosis. They are painful, recurrent, hard to heal, carry an increased risk of infection, and are frequently responsible for pain and disability.

Photobiomodulation (PBM) with blue light was recently studied in the management of hard-to-heal wounds.

Our project could be considered a pilot study that primarily served to assess the feasibility and safety of the EmoLED® device; we also aimed to evaluate the treatment efficacy in the heterogeneous framework of SSc-SU.

The application of blue light PBM with EmoLED® in addition to debridement apparently produced faster healing of SU, with the formation of granulation tissue and regularization of margins.

EmoLED® could be a promising safe, effective, noninvasive tool to treat SSc-SU, with an interesting role to play in the healing process in addition to conventional systemic and local therapies.

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