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Telangiectasis in CREST syndrome and systemic sclerosis: correlation of clinical and pathological features with response to pulsed dye laser treatment

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Abstract

Telangiectasia are cardinal features of systemic sclerosis (SS) and calcinosis, Raynaud’s syndrome, esophageal motility, sclerodactyly, telangiectasias (CREST) syndrome. The etiology of telangiectasia in these syndromes is unknown, but vascular dysfunction has been proposed. However, the telangiectasia of CREST have anecdotally been considered relatively resistant to pulse dye laser (PDL), the treatment of choice for classic telangiectasia. The study was designed to test whether SS/CREST telangiectasia require more treatments than sporadic telangiectasia and to identify clinical and histological features that could explain such an effect. Nineteen skin biopsies from patients with SS or CREST and 10 control biopsies were examined and compared for features that may predict a differential response to PDL. Sixteen cases of SS or CREST treated with PDL between 1997 and 2007 were evaluated and response to treatment was compared with 20 patients with sporadic telangiectasis. Relative to normal skin, CREST/scleroderma telangiectasia exhibited thickened vessels in 17 out of 19 sections and thickened collagen fibers in the reticular or deep dermis in all sections. The number of treatments required to clear SS/CREST telangiectasia was approximately twofold higher. SS/CREST telangiectasia are more resistant to PDL but can be effectively cleared with more treatments.

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Authors and Affiliations

  1. Laser Unit, Department of Dermatology, Rabin Medical Center, Petach Tikva, Israel

    Shlomit Halachmi, Osama Gabari, Sarit Cohen & Moshe Lapidoth

  2. Department of Pathology, Rabin Medical Center, Petach Tikva, Israel

    Romelia Koren

  3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Romelia Koren, Dan Ben Amitai & Moshe Lapidoth

  4. Department of Dermatology, Schneider Childern’s Hospital, Petach Tikva, Israel

    Dan Ben Amitai

Authors
  1. Shlomit Halachmi
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  2. Osama Gabari
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  3. Sarit Cohen
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  4. Romelia Koren
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  5. Dan Ben Amitai
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  6. Moshe Lapidoth
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Correspondence to Shlomit Halachmi.

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Halachmi, S., Gabari, O., Cohen, S. et al. Telangiectasis in CREST syndrome and systemic sclerosis: correlation of clinical and pathological features with response to pulsed dye laser treatment. Lasers Med Sci 29, 137–140 (2014). https://doi.org/10.1007/s10103-013-1298-1

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  • DOI: https://doi.org/10.1007/s10103-013-1298-1

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