Hyperbaric Oxygen Therapy May Have a Favorable Affect on Skin Thickness in Systemic Sclerosis: Experience with Four Patients.

Objective: Hyperbaric oxygen (HBO2) therapy has well-known anti-inflammatory and antifibrotic effects. It may be an option for the treatment of chronic wounds including digital ulcers related with systemic sclerosis (SS). The therapy may also have an impact on the fibrotic complications of SS, including skin thickness. The aim of the study was evaluating the effect of HBO2 on skin thickness in SS patients with medical therapy resistant digital ulcers. Methods: This was an observational study. Twenty-five of 68 patients in our SS cohort had digital ulcers. Four of those had medical therapy resistant digital ulcers. First, we administered at least three of the drugs: Calcium channel blockers, acetylsalicylic acid, iloprost and bosentan as combination therapy. Then, unresponsive patients were evaluated together by rheumatologist and underwater and hyperbaric medicine physician for HBO2 indication. Finally, we applied HBO2 to eligible patients for their refractory and active digital ulcers. We evaluated the pre- and post-therapy values of modified Rodnan skin score (mRSS) for skin thickness, health assessment questionnaire for disease-related disability, short-form 36 test for quality of life, and visual analog scores related to skin thickness. Results: mRSSs of all patients improved after the therapy. Nevertheless, we observed that only one patient's digital ulcers got better with the therapy. Furthermore, disease-related disability and quality of life indices were not improved consistently according to the favorable changes in skin scores. Conclusion: HBO2 may have a positive effect on skin thickness due to its anti-inflammatory and antifibrotic effects. Disease-related disability and quality of life parameters may improve further with addressing all aspects of the disease. [ABSTRACT FROM AUTHOR]