Light therapy delivered locally using a lamp that emits infrared, red and ultraviolet light reduced by 83 percent the burden of digital ulcers in systemic sclerosis (SSc) patients, a new study reports.
The study, “A feasibility study of a novel low-level light therapy for digital ulcers in systemic sclerosis,” was published in the Journal of Dermatological Treatment.
Patients with SSc frequently develop digital ulcers, which are small sores that form on the fingers and toes as the result of impaired blood flow.
While several treatment strategies have been developed for this condition, “recurrent ulceration remains a major source of morbidity in some patients with SSc,” researchers wrote. The use of vasodilators — such as losartan, diltiazem, nifedipine, and iloprost — is a common therapeutic approach, although they are discontinued when poorly tolerated. Therapies that act locally on digital ulcers skipping the systemic vasodilation are likely to be better tolerated.
Researchers at the University of Manchester and Salford Royal NHS Foundation Trust developed a low-level light therapy using a lamp that combines infrared, red and ultraviolet light to treat chronic digital ulcers.
An increasing number of studies have reported the positive effects of low-level light therapy in skin ulcers of diabetic patients. The light combination is thought to stimulate several processes; for example, the red and infrared light boost blood flow and with it the nutrients required for wound healing.
Moreover, infrared light — the same used in TV remote controls — increases the tissue’s oxygenation, while red light enhances the body’s antimicrobial defenses. Red light also is reported to induce the deposition of collagen, the wounds’ natural scaffolding.
Ultraviolet light — invisible to the naked eye — has an anti-bacterial effect and reduces inflammation, which acts against healing.
The new lamp developed by the team is composed of 32 different bulbs which emit infrared, red or ultraviolet light.
Researchers tested its effects in eight SSc patients who had a total of 14 ulcers. Treatment with the lamp was performed in 15-minute sessions, twice a week for three weeks. The majority of patients also were receiving treatment with vasodilatory agents.
Results showed that a total of 46 light treatments were administered successfully without raising any safety concerns. Moreover, the level of pain reported by the patients was low.
Importantly, after completion of the treatment, patients reported a reduction of 82.8 percent in digital ulcers’ burden compared to the beginning (baseline) of the study.
Researchers used a second technique, called laser Doppler imaging, to measure digital ulcers healing. The technique was performed immediately before and after light exposures at the site of the digital ulcer. Results showed that following light therapy there was a significant increase in blood flow within the digital ulcers and in the surrounding tissue.
Currently, patients may receive light therapy at the hospital to treat ulcers, but this requires a period of five days of treatment and medications. However, the new lamp can be used at home.
“Ulcers cause much distress to patients — and current treatments are costly to the [National Health Service] and problematic for patients who can only receive them in hospital,” Michael Hughes, University of Manchester, the study’s first author said in a press release. “But this technology is cheap and practical — it’s really a no brainer as it can be administered at home.”
Moreover, the lamp may be adapted to allow clinicians to monitor patients’ progress remotely.
“There are future possibilities,” Hughes said. “We think this device could be easily adapted to monitor ulcers remotely using cameras. They could also be programmed to recognize different parts of the body so that the treatment is given accurately.”
According to the Hughes, “this technology is a game changer; the implications are huge.”
So far the results support the potential of the newly developed light therapy to treat SSc digital ulcers locally. Researchers now plan to test the new light therapy in diabetic ulcers, a common complication in patients with diabetes.
“In the next 6 to 12 months we shall be refining the machine and within 12 months we hope to [trying] it on diabetic ulcers,” Hughes concluded.
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