title: A comparison of intense pulsed light and laser treatment of telangiectases in patients with systemic sclerosis: a within-subject randomized trial.
abstract: OBJECTIVE
  Cutaneous telangiectases are a characteristic and psychologically distressing feature of SSc. Our aim was to assess the efficacy of two light-based treatments: pulsed dye laser (PDL) and intense pulsed light (IPL).
  
  
  METHODS
  Nineteen patients with facial or upper limb telangiectases underwent three treatments with PDL and IPL (randomly assigned to left- and right-sided lesions). Outcome measures were clinical photography (assessed by two clinicians), dermoscopy (assessed by two observers), laser Doppler imaging (LDI) and observer and patient opinion, including patient self-assessment psychological questionnaires [Hospital Anxiety and Depression Scale (HADS), Adapted Satisfaction with Appearance Scale (ASWAP)].
  
  
  RESULTS
  Comparison between 16-week follow-up and baseline photography scores (from -2 to +2 on a Likert scale, with >0 being improvement) were a mean score for PDL of 1.7 (95% CI 1.4, 2.0) and for IPL 1.4 (0.9, 1.8), with a mean difference between PDL and IPL of -0.3 (-0.5, -0.1) (P = 0.01). Dermoscopy scores also improved with both therapies: PDL 1.3 (1.1, 1.5) and IPL 0.8 (0.5, 1.1), again greater with PDL (P = 0.01). LDI showed decreases in blood flow at 16 weeks, indicating a response to both therapies. All patients reported benefit from treatment (more preferred PDL at 16 weeks). Psychological questionnaires also indicated improvement after therapy with mean change in ASWAP of -13.9 (95% CI -20.5, -7.4). No side effects were reported for IPL; PDL caused transient bruising in most cases.
  
  
  CONCLUSIONS
  Both PDL and IPL are effective treatments for SSc-related telangiectases. Outcome measures indicate that PDL has better outcomes in terms of appearance, although IPL had fewer side effects.
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Dinsdale
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Murray
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Tonia
authors.initials: T
authors.lastname: Moore
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Janice
authors.initials: J
authors.lastname: Ferguson
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Jack
authors.initials: J
authors.lastname: Wilkinson
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Richards
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Christopher E M
authors.initials: CE
authors.lastname: Griffiths
authors.affiliation: Centre for Musculoskeletal Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, The University of Manchester, Manchester Academic Health Science Centre, Photon Science Institute, University of Manchester, Manchester, Department of Clinical Dermatology, Salford Royal NHS Foundation Trust, Research and Development, Salford Royal NHS Foundation Trust, Salford, UK, Department of Clinical Health Psychology, Mercy University Hospital, Grenville Place, Cork, Ireland and Centre for Dermatology Research, Institute of Inflammation and Repair, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. ariane.herrick@manchester.ac.uk.
authors.forename: Ariane L
authors.initials: AL
authors.lastname: Herrick
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054025:Lasers, Dye; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications*; D013684:Telangiectasis / Q000150:complications / Q000532:radiotherapy*; D016896:Treatment Outcome
keywords: intense pulsed light; laser; systemic sclerosis; telangiectases; treatment