Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life Evaluation.
Calidad de vida
Dual 595/1064-nm wavelength laser
Dual sequential PDL-Nd:YAG laser
Hereditary haemorrhagic telangiectasia
Láser Nd:YAG
Láser de estado sólido
Láser dual de longitud de onda de 595/1064nm
Láser dual secuencial PDL-Nd:YAG
Nd:YAG laser
Quality of life
Solid-state laser
Telangiectasia hemorrágica hereditaria
Journal
Actas dermo-sifiliograficas
ISSN: 1578-2190
Titre abrégé: Actas Dermosifiliogr
Pays: Spain
ID NLM: 0373062
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
received:
31
07
2023
revised:
02
10
2023
accepted:
16
10
2023
medline:
12
3
2024
pubmed:
2
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet. To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy. A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction. 111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported. DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
Sections du résumé
BACKGROUND
BACKGROUND
Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet.
OBJECTIVE
OBJECTIVE
To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy.
METHODS
METHODS
A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction.
RESULTS
RESULTS
111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported.
CONCLUSIONS
CONCLUSIONS
DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
Identifiants
pubmed: 37913989
pii: S0001-7310(23)00848-7
doi: 10.1016/j.ad.2023.10.017
pii:
doi:
Substances chimiques
Aluminum
CPD4NFA903
Neodymium
2I87U3734A
Yttrium
58784XQC3Y
yttrium-aluminum-garnet
0
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
246-257Informations de copyright
Copyright © 2023 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.