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J Dermatolog Treat. 2018 Jul 31:1-7. doi: 10.1080/09546634.2018.1484875. [Epub ahead of print]

A feasibility study of a novel low-level light therapy for digital ulcers in systemic sclerosis.

Author information

1
a Centre for Musculoskeletal Research , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.
2
b Department of Rheumatology , Salford Royal NHS Foundation Trust , Salford , UK.
3
c Research and Development , Salford Royal NHS Foundation Trust , Salford , UK.
4
d Medical Physics Department and University of Manchester , Manchester Academic Health Science Centre , Salford Royal NHS Foundation Trust , UK.
5
e Medical Physics Department , Salford Royal NHS Foundation Trust , UK.
6
f Centre for Biostatistics , Institute of Population Health, School of Medicine, The University of Manchester , Manchester , UK.
7
g Photobiology Unit, Dermatology Centre, Division of Musculoskeletal and Dermatological Sciences , The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK.
8
h NIHR Manchester Musculoskeletal Biomedical Research Centre , Central Manchester NHS Foundation Trust , Manchester Academic Health Science Centre , UK.
9
i Photon Science Institute , The University of Manchester , UK.

Abstract

BACKGROUND:

Locally acting, well-tolerated treatments for systemic sclerosis (SSc) digital ulcers (DUs) are needed.

OBJECTIVES:

Our primary aim was to investigate the safety, feasibility, and tolerability of a novel low-level light therapy (LTTT). A secondary aim was to tentatively assess efficacy.

METHODS:

A custom-built device comprising infrared (850 nm), red (660 nm), and violet (405 nm) LEDs was utilized. DUs were irradiated with 10 J/cm2 twice weekly for 3 weeks, with follow-up at weeks 4 and 8. Any safety concerns were documented. Patient opinion on time to deliver, feasibility, and pain visual analogue score (VAS; 0-100, 100 most severe) was collected. Patient and clinician DU global assessment VAS were documented. DUs were evaluated by laser Doppler perfusion imaging pre- and post-irradiation.

RESULTS:

In all, 14 DUs in eight patients received a total of 46 light exposures, with no safety concerns. All patients considered LTTT 'took just the right amount of time' and was 'feasible', with a low associated mean pain VAS of 1.6 (SD: 5.2). Patient and clinician global DC VAS improved during the study (mean change: -7.1 and -5.2, respectively, both p < .001). DU perfusion significantly increased post-irradiation.

CONCLUSIONS:

LTTT for DUs is safe, feasible, and well tolerated. There was an early tentative suggestion of treatment efficacy.

KEYWORDS:

Systemic sclerosis; digital ulcers; phototherapy; scleroderma

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