Photobiomodulation Therapy: A New Light in the Treatment of Systemic Sclerosis Skin Ulcers

Abstract

Introduction Skin ulcers (SU) represent one of the most frequent manifestations of systemic sclerosis (SSc), occurring in almost 50% of scleroderma patients. SSc-SU are often particularly difficult to treat with conventional systemic and local therapies. In this study, a preliminary evaluation of the role and effectiveness of blue light photobiomodulation (PBM) therapy with EmoLED ® in the treatment of scleroderma skin ulcers (SSc-SU) was performed. Methods We retrospectively analyzed 12 consecutive SSc patients with a total of 15 SU on finger hands. All patients were treated with adequate systemic therapy and local treatment for SU; after a standard skin ulcer bed preparation with debridement of all lesions, EmoLED ® was performed. All patients were locally treated every week during 2 months of follow-up; SU data were collected after 4 weeks (T4) and 8 weeks (T8). Eight SSc patients with comparable SU were also evaluated as controls. Results The application of EmoLED ® in addition to debridement apparently produced faster healing of SU. Complete healing of SU was recorded in 41.6% cases during EmoLED ® treatment. Significant improvements in SU area, length, and width, wound bed, and related pain were observed in EmoLED ® patients from T0 to T8. Control subjects treated with standard systemic/local therapies merely showed an amelioration of SU area and width at the end of the follow-up. No procedural or post-procedural adverse events were reported. Conclusions The positive clinical results and the absence of side effects suggest that EmoLED ® could be a promising tool in the management of SSc-SU, with an interesting role to play in the healing process in addition to conventional systemic and local treatments.

Photobiomodulation with Blue Light on Wound Healing: A Scoping Review

“…Five studies were included in the clinical category ( Table 4 ) [ 75 , 76 , 77 , 78 , 79 ], totaling 64 patients with wounds of different etiologies that were evaluated before and after light application. One of these studies evaluated the effect of BL on 12 patients; the control group comprised 8 patients who were not irradiated [ 79 ].…”

Low-Dose Blue Light (420 nm) Reduces Metabolic Activity and Inhibits Proliferation of Human Dermal Fibroblasts

“…The authors suggested that the photobiomodulation of the wounds with blue light evokes a mast cell response, which, in turn, stimulates an early inflammatory response, angiogenesis, and myofibroblast differentiation [ 59 ]. In patients ( n = 12) with systemic sclerosis skin ulcers, the weekly treatment of the ulcers with blue light (400–430 nm, 120 mW/cm 2 , 7.2 J/cm 2 ), in addition to the standard therapy, showed significant improvements after 8 weeks [ 60 ]. The same device was used in a study for the treatment of chronic wounds.…”

Highlighting nuances of blue light phototherapy: Mechanisms and safety considerations

“…As the quest for a light therapy offering more attractive risk-benefit ratio continues, the lower energy blue light photons, spanning the 400-495 nm range, being the "nearest neighbor" of UVR (i.e., UVA) has become the focus of attention. By now, a significant increase in the clinical use of the blue light phototherapy has been reported [8,39,48,49] including PDT of AK [19], treatment of neonatal jaundice [50], acne [19,49,[58][59][60][61][62][63][64][65], psoriasis vulgaris [48,[67][68][69][70]101], eczema [48,71,93], alopecia [51], blood pressure reduction [52], stimulation of endorphin release [53], chronic wound healing [55][56][57], and many more, where the efficacy and thus the benefits of blue light therapies is evidenced from numerous clinical studies.…”

“…In an attempt to find a "safer" yet effective therapy, the last decade has witnessed a significant increase in the use of the blue light (400-495 nm) within the parameter window (irradiance and exposure time), which induces photobiological effects [8,39,48,49]. Applications include its use as an exogenous photosynthesizer in the treatment of actinic keratosis (AK) during photodynamic therapy (PDT) [19] and on endogenous molecular targets in neonatal jaundice [50], acne [19,49], psoriasis vulgaris [48], eczema [48] alopecia [51], blood pressure reduction [52], stimulation of endorphin release [53], pain relief [54], chronic wounds [55][56][57], and so forth.…”