Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium
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 ha...
| Authors: | , , , , , , , |
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| Format: | article |
| Publication Date: | 2024 |
| Country: | España |
| Institution: | Universitat Autònoma de Barcelona |
| Repository: | Dipòsit Digital de Documents de la UAB |
| Language: | Spanish |
| OAI Identifier: | oai:ddd.uab.cat:305613 |
| Online Access: | https://ddd.uab.cat/record/305613 https://dx.doi.org/urn:doi:10.1016/j.ad.2024.01.003 |
| Access Level: | Open access |
| Keyword: | 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 |
| Summary: | 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 595/1064 nm laser (DWSL) compared to 1064 nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy. 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. 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. |
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