In this study, the investigators seek to evaluate the effects of a laser treatment on the redistribution/regeneration of collagen on the clinical, microscopic, and molecular profiles of hypertrophic scars and scleroderma.
This study is designed to evaluate the efficacy of laser treatment for the improvement of the clinical appearance of disorders of collagen metabolism, including hypertrophic scars and scleroderma. The investigators will be performing a prospective cohort study. The entire lesion will receive laser treatment only. The investigators plan to have 20 patients (10 patients with hypertrophic scars and 10 patients with scleroderma) complete the study. Subjects must be equal to greater than 18 years old, but may be any gender or Fitzpatrick skin type. They must have one of the following: at least one extragenital hypertrophic scar, or at least one extragenital area of scleroderma . Subjects must not have received any prescription or in-clinic medications or treatments, such as intralesional corticosteroids or excision, on the eligible scars/scleroderma in the previous 3 months. Those on anti-inflammatory or immunosuppressive medications will also be excluded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Patients will receive three laser treatments at one-month intervals.
MGH Clinical Unit for Research Trials & Outcomes in Skin
Boston, Massachusetts, United States
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
Time frame: baseline, pre-intervention
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
Time frame: 1 month after baseline
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
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Time frame: 2 months after baseline
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
Time frame: 3 months after baseline
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
Time frame: 4 months after baseline
Physician's Global Assessment Scale
A score of 0 denotes "No evidence of disease, 100% improvement" and "Completely clear." A score of 1 denotes "Very significant clearance (≥90% to 100%); only traces of disease remain" and "Almost Clear." A score of 2 denotes "Significant improvement(≥75% to \< 90%); some evidence of disease remains" and "Marked Improvement." A score of 3 denotes "Intermediate between slight and marked improvement (≥50% to \<75%)" and "Moderate Improvement." A score of 4 denotes "Some improvement (≥25% to \<50%); significant evidence of disease remains" and "Slight Improvement ." A score of 5 denotes "Disease has not changed from baseline (+ or - \<25%)" and "No Change." A score of 6 denotes "Disease is worse than at baseline by ≥25% or more" and "Worse."
Time frame: Up to 1 year after baseline
Mouth Handicap in Systemic Sclerosis scale
To assess facial scleroderma
Time frame: Compare baseline to post-procedural
Vancouver Scar Scale
To assess all scars, facial and non-facial
Time frame: Compare baseline to post-procedural
Range of Motion Evaluation
For non-facial scleroderma to evaluate range of motion of the joint by assessing flexion, extension, supination, and pronation using a goniometer
Time frame: Compare baseline to post-procedural