Pulsed dye laser in the treatment of localized scleroderma and its effects on CD34+ and factor XIIIa+ cells: an immunohistochemical study.

Abstract

BACKGROUND:

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.

OBJECTIVE:

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.

STUDY DESIGN:

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.

RESULTS:

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.

CONCLUSION:

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.

• Authors: Abeer Attia Tawfik, Hisham Shokir, Mona Soliman, Lila Salah, Sahar Fathy
• Journal: American journal of clinical dermatology (Am J Clin Dermatol) Vol. 14 Issue 3 Pg. 235-41 (Jun 2013) ISSN: 1179-1888 [Electronic] New Zealand
• PMID: 23645504 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antigens, CD34
• Factor VIIIa
• Collagen

Topics

• Adolescent
• Adult
• Antigens, CD34 (biosynthesis)
• Blood Vessels (radiation effects)
• Case-Control Studies
• Collagen (antagonists & inhibitors, metabolism)
• Dendritic Cells (metabolism, radiation effects)
• Factor VIIIa (biosynthesis)
• Female
• Humans
• Immunohistochemistry
• Lasers, Dye (therapeutic use)
• Male
• Patient Satisfaction
• Scleroderma, Localized (radiotherapy)
• Skin (radiation effects)
• Young Adult