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A tunable pulsed dye laser emitting at 577 nm and 360 μs pulse width was used to treat benign cutaneous vascular ectasias other than port wine stain in 77 patients. Except for leg telangiectasias (34 patients), the overall response was excellent. Forty-two of forty-five patients with hemangiomas, spider nevi, angioma serpiginosum, venous lakes or facial telangiectasias showed excellent results after 1–4 consecutive treatments. Scarring was observed in none of the patients. These results confirm previous data on the use of the tunable dye laser in the treatment of port wine stain, and suggest that 577 nm wavelength and 360 μs pulse width allow the selective photothermolysis of vascular cutaneous ectasias with better clinical results than previously reported.

A flashlamp-pumped pulsed dye laser at 577 nm was evaluated in the treatment of port-wine stains. The degree of lesional lightening was compared following laser exposure with pulse durations of 20 and 360 microseconds. In addition, lesional therapy using the 360-microseconds pulse duration was evaluated for lightening and side effects following long-term patient observation and after repeated treatments of the same site. A total of 52 patients with port-wine stain were treated; their average age was 29 years, with eight patients less than 18 years, of whom 29 had comparative test site placement for the different pulse durations. Of these 29 patients, 25 demonstrated greater lightening at the 360-microseconds pulse duration test site. All 52 patients proceeded to receive full treatment placement with the 360-microseconds pulse duration, which resulted in an overall lightening of 42% after the initial treatment and 68% after re-treatment sessions. Forty-four percent of the patients had equal to or greater than 75% lesional lightening. Pretreatment anesthesia was unnecessary and only minimum posttreatment care was required. Mild adverse effects of epidermal change, depression, or pigmentary change appeared in only four cases and was limited to less than a 2% area in each of these lesions. These side effects did not recur when the lesions were re-treated at lower energy dosages. No posttreatment sclerosis or scarring appeared, even after multiple retreatment sessions to the same area, regardless of the anatomic location, color of the lesion, or age of the patient.(ABSTRACT TRUNCATED AT 250 WORDS)

The stratum corneum (SC) (i.e., the outermost layer of human skin) is a complex and paradoxical tissue composed of corneocytes and a matrix of intercellular lipids playing an essential role as the skin's protective barrier. The first paradox of SC is its dual nature. It is composed of nondividing (dead) cells embedded in a metabolically active (live) environment whose function is to protect the epidermis and to maintain its integrity. In order to do so, the SC uses various strategies, including enzymatic reactions, colonization by bacterial flora, immune signaling, antimicrobial lipids and peptides, low pH, antioxidants, and natural moisturizing factor(s). The second paradox is that although its biological function is essentially that of a physicochemical barrier, cosmetologists and pharmacists are actively exploring paths for penetration through the SC to allow passage of active molecules and their penetration into the skin. Various pathways of penetration and physicochemical factors facilitating this penetration into the dermis and/or the epidermis have been defined, but the exact mechanisms of penetration of cosmetic ingredients remain elusive. For cosmetologists and pharmacists, the SC represents a major focus of interest whether for basic research or the development of novel topical approaches taking into account the fascinating properties of this complex tissue.

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