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Pulsed Dye Laser in the Treatment of Localized Scleroderma and Its Effects on CD34+ and Factor XIIIa+ Cells: An Immunohistochemical Study

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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/cm2. 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.

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Acknowledgments

No sources of funding were received to prepare this study. The authors have no conflicts of interest directly relevant to the content of this study.

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Authors and Affiliations

  1. 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

    Abeer Attia Tawfik, Hisham Shokir & Mona Soliman

  2. Department of Pathology, Faculty of Medicine, Banha University, Zagazig, Egypt

    Lila Salah

  3. Al Houd Al Marsoud Dermatology Hospital, Al Saiada Zenib Square, Cairo, Egypt

    Sahar Fathy

Authors
  1. Abeer Attia Tawfik
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  2. Hisham Shokir
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  3. Mona Soliman
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  4. Lila Salah
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  5. Sahar Fathy
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Correspondence to Abeer Attia Tawfik.

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Tawfik, A.A., Shokir, H., Soliman, M. et al. Pulsed Dye Laser in the Treatment of Localized Scleroderma and Its Effects on CD34+ and Factor XIIIa+ Cells: An Immunohistochemical Study. Am J Clin Dermatol 14, 235–241 (2013). https://doi.org/10.1007/s40257-013-0027-7

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  • DOI: https://doi.org/10.1007/s40257-013-0027-7

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