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
Por:
Cubiró X, Garcia-Melendo C, Morales-Munera CE, Riera-Mestre A, Torres-Iglesias R, Villanueva B, Puig L and Baselga E
Publicada:
1 mar 2024
Ahead of Print:
1 mar 2024
Resumen:
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: 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 (R) tests and assessed procedure -associated pain and patient satisfaction. 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: 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. (c) 2023 AEDV. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Filiaciones:
Cubiró X:
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Department of Dermatology, Hospital de Mollet, Mollet del Vallès, Barcelona, Spain
Garcia-Melendo C:
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Department of Dermatology, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
Morales-Munera CE:
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Riera-Mestre A:
Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
Torres-Iglesias R:
Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
Villanueva B:
Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
Puig L:
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Baselga E:
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain
Universitat Autònoma de Barcelona, Barcelona, Spain
Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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