Experience of successful use of intense pulsed light in the treatment of Shamberg patients

Abstract

Schamberg's disease (chronic purpura pigmentosa) is the most common type of pigmentary purpuric dermatosis, most commonly seen in men and primarily affecting the areas of the tibia, thighs, buttocks, trunk, or upper extremities, with a classic presentation characterized by petechiae, purpura, and enhancement skin pigmentation. This is a benign disease that is often asymptomatic and requires treatment if there are associated symptoms or if the patient wishes to improve a cosmetic defect.

Schamberg's disease is usually not difficult to diagnose, but its treatment can be challenging. The current standard of treatment for chronic purpura pigmentosa includes systemic and external drug therapy, correction of identified concomitant diseases that can maintain and worsen the course of cutaneous vasculitis. There are many other, including non-pharmacological, methods described in the literature, few of which have been shown to be effective. Considering the small number of studies on this topic, numerous exacerbations and the possibility of spontaneous resolution of the disease, patients’ concerns about residual pigmentation, the search for an optimal therapeutic approach remains an urgent task.

This article describes the experience of using broadband pulsed light in the treatment of Schamberg disease in a 34-year-old man. The equipment settings, diagram and exposure protocol for broadband pulsed light are presented. As a result of a follow-up examination carried out 1 month after treatment, a positive dynamic of the therapeutic process was determined: there were no new rashes, individual foci of the rash regressed completely, the remaining elements of the rash paled significantly. At a follow-up examination, four months after the therapy, a stable treatment result was recorded.

Keywords

case report / Schamberg disease / pulsed light / pigmented purpuric dermatosis / cutaneous hemosiderosis

References

[1] Taketuchi Y, Chinen T, Ichikawa Y, Ito M. Two cases of unilateral pigmented purpuric dermatosis. J Dermatol. 2001;28(9):493–498. doi: 10.1111/j.1346-8138.2001.tb00018.x

[2] Taketuchi Y., Chinen T., Ichikawa Y., Ito M. Two cases of unilateral pigmented purpuric dermatosis // J Dermatol. 2001. Vol. 28, N 9. P. 493–498. doi: 10.1111/j.1346-8138.2001.tb00018.x

[3] Sardana K, Sarkar R, Sehgal VN. Pigmented purpuric dermatoses: An overview. Int J Dermatol. 2004;43(7):482–488. doi: 10.1111/j.1365-4632.2004.02213.x

[4] Sardana K., Sarkar R., Sehgal V.N. Pigmented purpuric dermatoses: An overview // Int J Dermatol. 2004. Vol. 43, N 7. P. 482–488. doi: 10.1111/j.1365-4632.2004.02213.x

[5] Zaldivar Fujigaki JL, Anjum F. Schamberg disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.

[6] Zaldivar Fujigaki J.L., Anjum F. Schamberg disease // StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023.

[7] Zvulunov A, Avinoach I, Hatskelzon L, Halevy S. Pigmented purpuric dermatosis (Schamberg’s purpura) in an infant. Dermatol Online J. 1999;5(1):2.

[8] Zvulunov A., Avinoach I., Hatskelzon L., Halevy S. Pigmented purpuric dermatosis (Schamberg’s purpura) in an infant // Dermatol Online J. 1999. Vol. 5, N 1. P. 2.

[9] Federal Clinical Guidelines. Dermatovenerology, 2015: Diseases of the skin. Sexually transmitted infections. 5th ed., revised and updated. Moscow: Delovoy Express; 2016. 768 p. (In Russ).

[10] Федеральные клинические рекомендации. Дерматовенерология, 2015: Болезни кожи. Инфекции, передаваемые половым путем. 5-е изд., перераб. и доп. Москва: Деловой экспресс, 2016. 768 с.

[11] Clinical Guidelines. Vasculitis restricted to the skin (L95). Russian Society of Dermatovenerologists and Cosmetologists; 2020. (In Russ).

[12] Клинические рекомендации. Васкулиты, ограниченные кожей (L95). Российское общество дерматовенерологов и косметологов, 2020.

[13] Seckin D, Yazici Z, Senol A, Demircay Z. A case of Schamberg’s disease responding dramatically to PUVA treatment. Photodermatol Photoimmunol Photomed. 2008;24(2):95–96. doi: 10.1111/j.1600-0781.2008.00337.x

[14] Seckin D., Yazici Z., Senol A., Demircay Z. A case of Schamberg’s disease responding dramatically to PUVA treatment // Photodermatol Photoimmunol Photomed. 2008. Vol. 24, N 2. P. 95–96. doi: 10.1111/j.1600-0781.2008.00337.x

[15] D’Ambrosia RA, Rajpara VS, Glogau RG. The successful treatment of Schamberg’s disease with the 595 nm vascular laser. Dermatol Surg. 2011;37(1):100–101. doi: 10.1111/j.1524-4725.2010.01822.x

[16] D’Ambrosia R.A., Rajpara V.S., Glogau R.G. The successful treatment of Schamberg’s disease with the 595 nm vascular laser // Dermatol Surg. 2011. Vol. 37, N 1. P. 100–101. doi: 10.1111/j.1524-4725.2010.01822.x

[17] Hilerowicz Y, Sprecher E, Gat A, Artzi O. Successful treatment of Schamberg’s disease with fractional non-ablative 1540 nm erbium:glass laser. J Cosmet Laser Ther. 2018;20(5):265–268. doi: 10.1080/14764172.2017.1418513

[18] Hilerowicz Y., Sprecher E., Gat A., Artzi O. Successful treatment of Schamberg’s disease with fractional non-ablative 1540 nm erbium: Glass laser // J Cosmet Laser Ther. 2018. Vol. 20, N 5. P. 265–268. doi: 10.1080/14764172.2017.1418513

RIGHTS & PERMISSIONS

Eco-Vector