title: Pilot study of intense pulsed light for the treatment of systemic sclerosis-related telangiectases.
abstract: BACKGROUND
  Telangiectases represent microvascular changes inherent in the systemic sclerosis (SSc) disease process. Intense pulsed light (IPL) is an effective treatment for non-SSc-related cutaneous telangiectases.
  
  
  OBJECTIVE
  This pilot study aimed to examine the efficacy, safety and tolerability of IPL treatment in an open study of patients with SSc.
  
  
  METHODS
  Patients underwent three treatments of IPL at monthly intervals and attended follow-up examinations at 1, 6 and 12 months after final treatment. Photographs, laser Doppler imaging (LDI) and thermography were used to measure changes at each visit.
  
  
  RESULTS
  Seventeen patients completed the study. Photographs were graded (compared with baseline) as: at 1-month follow-up, four 'no change', four 'improved' and eight 'much improved'; at 6-month follow-up, four 'no change', eight 'improved'; and four 'much improved'; and at 12-month follow-up (eight images were available), three 'no change', two 'improved' and three 'much improved'. Perfusion as measured by LDI (perfusion units) was significantly reduced, compared with baseline [median 2·66, interquartile range (1·78-3·93)], at 1 month [1·70 (1·07-2·55), P = 0·006] and 6 months [2·05 (1·42-2·36), P = 0·008] post-treatment, but not at 12 months [1·61 (1·14-3·22), P =0·088]. No differences were found in skin temperature between baseline and follow-up visits.
  
  
  CONCLUSIONS
  In this pilot study (the first of IPL treatment for SSc-related telangiectases) most patients improved after IPL treatment. However, the degree of improvement was not maintained in all patients at 6-12 months, suggesting that further treatments may be necessary. Longer term studies of this novel treatment approach are now required.
authors.affiliation: Musculoskeletal Research Group, School of Translational Medicine Dermatology Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK. andrea.murray@manchester.ac.uk
authors.forename: A K
authors.initials: AK
authors.lastname: Murray
authors.forename: T L
authors.initials: TL
authors.lastname: Moore
authors.forename: H
authors.initials: H
authors.lastname: Richards
authors.forename: H
authors.initials: H
authors.lastname: Ennis
authors.forename: C E M
authors.initials: CE
authors.lastname: Griffiths
authors.forename: A L
authors.initials: AL
authors.lastname: Herrick
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012595:Scleroderma, Systemic / Q000150:complications / Q000601:surgery*; D017445:Skin Diseases, Vascular / Q000209:etiology / Q000601:surgery*; D013684:Telangiectasis / Q000209:etiology / Q000601:surgery*; D013817:Thermography; D016896:Treatment Outcome