Efficacy of fractional CO2 laser for improvement of limited mouth opening in systemic sclerosis

• Published in: Journal of cutaneous and aesthetic surgery Vol. 15; no. 4; pp. 387 - 393
• Main Authors: Bhat, Yasmeen, Bashir, Yaqzata, Latif, Insha, Daing, Amanullah, Devi, Reeta, Shah, Iffat, Akhtar, Saniya, Rather, Shagufta, Nabi, Nahida, Saqib, Najam
• Format: Journal Article
• Language: English
• Published: Mumbai Wolters Kluwer India Pvt. Ltd 01.10.2022; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow
• Subjects: Carbon dioxide; Lasers; Original; Scleroderma; Carbon dioxide (CO2) laser; limited mouth opening (LMO); systemic sclerosis; mouth handicap in systemic sclerosis (MHISS); diffuse cutaneous systemic sclerosis (dcSSc)
• ISSN: 0974-2077; 0974-5157
• DOI: 10.4103/JCAS.JCAS_29_21

Background: Systemic sclerosis is a multisystem auto-inflammatory disease-causing fibrosis in the skin and internal organs. A frequent complication of systemic sclerosis is the limited mouth opening (LMO), a difficult-to-treat condition with only a few treatment options available. Aims and Objectives: The aim of this study was to evaluate the response of fractional carbon dioxide (CO2) laser resurfacing in LMO associated with systemic sclerosis. Materials and Methods: This was a hospital-based prospective study in which diagnosed cases of systemic sclerosis were taken. Patients who had significant LMO and who gave informed consent were included in the study. Fractional CO2 laser treatment was performed in the perioral area. Patients were assessed at baseline, after three and six sessions, and 3 months after the last session. Assessment was done by measurement of the interincisor distance (IID) using a ruler and calculation of the mouth handicap in systemic sclerosis (MHISS) scale. Results: Improvement in IID occurred 3 months after the first session with a mean gain of +5 mm (range 2-7). At 6 months, a mean gain of +8.5 mm (range 7-10) in IID was observed (P < 0.001). The MHISS score decreased by a mean of 14 (range 11-17) (P < 0.001). All patients showed improvement of mouth opening, which allowed the patients to have better phonation and the patients were able to have proper dental care posttreatment in the form of brushing of teeth and other dental procedures. The adverse effects noted in these patients included erythema that resolved spontaneously or after icing posttreatment. Other adverse effects noted were stinging and burning sensations that were mild and transient. Conclusion: Fractional CO2 laser forms a safe, effective, and well-tolerated treatment modality for improvement of LMO in systemic sclerosis. Limitations: The limitations of this study were less number of patients and no long-term follow-up.