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 [Artículo traducido] Tratamiento comparativo de lesiones mucocutáneas en pacientes con telangiectasia hemorrágica hereditaria con láser dual secuencial de colorante pulsado y neodimio: itrio-aluminio-granate versus neodimio: itrio-aluminio-granate solo: un estudio controlado aleatorizado doble ciego con evaluación de la calidad de vida
Cubiró, Xavier (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Garcia-Melendo, Cristina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Morales-Munera, Caridad Elena (Institut de Recerca Sant Pau)
Riera-Mestre, Antoni (Institut d'Investigació Biomèdica de Bellvitge)
Torres-Iglesias, Raquel (Institut d'Investigació Biomèdica de Bellvitge)
Villanueva, B. (Institut d'Investigació Biomèdica de Bellvitge)
Puig Sanz, Lluís (Institut de Recerca Sant Pau)
Baselga, Eulalia (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Data:	2024
Resum:	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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Llengua:	Castellà
Document:	Article ; recerca ; Versió publicada
Matèria:	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
Publicat a:	Actas dermo-sifiliográficas, Vol. 115 Núm. 3 (marzo 2024) , p. T246-T257, ISSN 1578-2190

DOI: 10.1016/j.ad.2024.01.003
PMID: 37913989

12 p, 1.5 MB

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