THE USE OF LOCAL LONG-WAVE INFRARED IRRADIATION IN THE COMBINATION TREATMENT OF LOCALIZED SCLERODERMA

Background: Localized scleroderma often results in irreversible cosmetic abnormalities and if advanced, to organ dysfunction and disability. Pharmacological treatment is not effective enough and can cause adverse events and complications. Due to this fact, much attention is paid to non-medical approaches to this disorder that would be able to exert positive clinical and patho-physiological effects and potentiate the effects of medical treatment. Aim: To evaluate the effects of local long-wave infrared irradiation on the course of localized scleroderma and to assess therapeutic efficacy of this method combined with conventional pharmacological treatment. Materials and methods: Fifty five (55) patients with localized scleroderma were included into the study. The patients from the control group (n = 20) were administered conventional medical treatment for 14  to 20  days, including antibacterials, proteolytic enzymes, calcium antagonists, antioxidants, topical vasculoprotectors + microcirculation correctors, as well as applications of corticosteroids. The patients from the main group (n = 35), in addition to conventional medical treatment, were administered local long-wave infrared irradiation of the lesions (wavelength 4  to 16  mcm, once daily for 10  days). We assessed changes in edema and hyperemia on the borders of the lesion, the degree and extent of the process with a modified scoring system mRODNAN Skin Score, as well as microcirculatory vasculature by means of Spectrotest. Results: Compared to the control group, the patients with localized scleroderma who, in addition to conventional medical treatment, were administered local long-wave infrared irradiation, showed a  bigger reduction of mRODNAN index (2.2 ± 0.1 and 6.3 ± 0.5, respectively, р < 0.05), of oxygen saturation within the lesions (0.646 ± 0.04 and 0.9 ± 0.001 units, р < 0.05) and an increase of blood flow volume in the microcirculation (0.23 ± 0.045 and 0.091 ± 0.002 units, р < 0.05). They also demonstrated a quicker clinical improvement that was obvious at day 14 ± 2.3 (р < 0.05). In the control group, the clinical improvement was seen only at day 20 ± 4.2 (р < 0.05), with only a tendency towards a  decrease in oxygen saturation within the lesions (from 0.87 ± 0.01 to 0.817 ± 0.005) and an increase of blood flow volume in the micro-circulation (from 0.086 ± 0.004 to 0.1 ± 0.003 units). The conventional medical treatment did not result in full resolution of the local scleroderma elements, this was confirmed by the results of assessment with mRODNAN index (mean value before treatment in this group was 6.4 ± 0.5, after treatment, 5.3 ± 0.2, р ≥ 0.05). Conclusion: The study proved the clinical efficacy of local long-wave infrared irradiation in the combination treatment of localized scleroderma. This effect was seen in the normalization of microcirculation parameters, increase of blood flow, decrease of oxygen saturation within the lesions reflecting active reparation, as well as in better clinical efficacy and more quick effect.