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Enhancing sickle cell leg ulcer healing with combined photodynamic and photobiomodulation therapies: A pilot experience

Year: 2025

Type: article

Abstract: This study aimed to evaluate the safety and efficacy of combined photodynamic therapy (PDT) and photobiomodulation (PBM) in treating sickle cell leg ulcers (SCLUs), with a focus on pain reduction and enhanced healing. In this prospective, open-label, uncontrolled pilot study, ten SCD patients with 17 chronic leg ulcers received PDT and PBM treatments. Ulcer severity, pain levels, and microbiome changes were monitored, and clinical data were analyzed using appropriate statistical methods. Among the treated ulcers, 64.7 % (11 out of 17) showed significant healing, with 9 ulcers achieving complete closure. The average reduction in ulcer size was significant, with a median healing time of 123 days. Pain levels decreased significantly in 82.3 % of treated ulcers (p < 0.001), and a 75.4 % reduction in bacterial load was observed, alongside increased microbiome diversity (p < 0.05). Elevated levels of IL-6 and PSGL-1 were associated with non-healing ulcers, indicating their potential as prognostic biomarkers. The combined PDT and PBM therapy proved to be effective and safe for SCLUs, offering significant improvements in healing and pain reduction. These findings suggest that integrating PDT and PBM into standard care protocols could enhance the management of SCLUs. • PDT and PBM accelerated healing in 64.7 % of chronic sickle cell leg ulcers. • 75.4 % bacterial load reduction and increased microbiome diversity after PDT. • Pain scores decreased in 88.2 % of ulcers treated with PDT and PBM. • Elevated IL-6 and PSGL-1 linked to non-healing ulcers as prognostic biomarkers. • PDT and PBM demonstrated safety and effectiveness for recurrent SCLUs treatment.

Source: Journal of Tissue Viability

DOI: 10.1016/j.jtv.2025.100879