title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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: Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (N.I.L.E.S.), Cairo University, Giza 12316, Egypt. dr.abeertawfik@gmail.com
authors: Abeer Attia
authors: AA
authors: Tawfik
authors: Hisham
authors: H
authors: Shokir
authors: Mona
authors: M
authors: Soliman
authors: Lila
authors: L
authors: Salah
authors: Sahar
authors: S
authors: Fathy
mesh_terms: D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000096:biosynthesis*; D001808:Blood Vessels / Q000528:radiation effects; D016022:Case-Control Studies; D003094:Collagen / Q000037:antagonists & inhibitors / Q000378:metabolism; D003713:Dendritic Cells / Q000378:metabolism / Q000528:radiation effects*; D015944:Factor VIIIa / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D017060:Patient Satisfaction; D012594:Scleroderma, Localized / Q000532:radiotherapy*; D012867:Skin / Q000528:radiation effects; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D015944:Factor VIIIa; D003094:Collagen