Improvement of microstomia in scleroderma after intense pulsed light: A case series of four patients

Introduction : Intense pulsed light (IPL) treatment is well known for, for example, photo rejuvenation, where higher cut-off filters are used. The longer wavelengths penetrate deeper in the dermis leading to damage of the collagen and stimulation of new collagen formation, which lead to more soft and elastic skin. Microstomia in systemic sclerosis is the end result of excessive collagen deposition, which makes the perioral skin firm and tight. The patients have difficulties performing oral self-care, and even professional dental care can be complicated. Methods : Four patients with systemic sclerosis and microstomia were treated with IPL (Ellipse A/S Flex System, Denmark) in the perioral region. The patients received 3-5 treatments with 4-week interval. Oral opening was measured before and after treatments. Results : The oral opening increased approximately 1 mm per treatment in three patients. One patient had temporomandibular joint symptoms of locking and did not have any increase in mouth opening. All four patients felt softening of the perioral skin, and all four patients described that articulation, eating and tooth brushing had become easier. Conclusion : IPL can be a new adjunctive alternative in the non-surgical treatment of microstomia in patients with systemic sclerosis.