Objective: The flashlamp pulsed dye laser (FLPDL) is currently the treatment of choice for port-wine stains (PWS). We recently investigated whether a non-coherent intense pulsed light source (IPLS) would be effective in the therapy of PWS. Design and Patients:In order to evaluate the efficacy in treatment of PWS (especially adult-type dark and hypertrophic), a retrospective study of 37 patients (randomly selected) with a total of 40 PWS treated with IPLS was initiated. Clinical PWS characteristics recorded were color and location of the PWS. Data collected included treatment parameters (filters, pulse duration, fluence and pulse sequencing), % clearance, and side effects (purpura, blisters, crusting, altered pigmentation and scarring).Results: Good and complete (70-100 %) clearance was achieved in 28 of 40 PWS treated with IPLS. Average number of treatment sessions in PWS reaching 100 % clearance included 4.0 for pink PWS and 1.5 sessions for red PWS. Average number of sessions in purple PWS reaching good clearance (70-99%) was 4.2 sessions. Parameters used most frequently were 515 and 550 nm cut-off-filters, pulse duration of 2.5-5.0 ms and fluences of 24 to 60 J/cm 2 . Side effects included purpura in 76%, superficial blisters in 8% and crusting in 20%. Transient pigmentation changes were seen in 10.8% of patients (hypopigmentations in 8.1%, hyperpigmentation in 2.7%). No scarring was observed. Conclusion:IPLS presents an effective and safe method for treating PWS, especially dark and facial PWS.

Background and Objective: Due to its delicate location near the eye and the high recurrence rate, the therapy of xanthelasma palpebrarum is a difficult surgical task. Besides chemical, physical, and surgical procedures, various laser systems have been used to treat these lesions (argon laser, pulsed dye laser, and CO2 laser). This study was designed to critically evaluate the use of the ultrapulsed CO2 laser for the treatment of xanthelasma palpebrarum. Study Design / Materials and Methods:We report about the standardized treatment of 23 patients (52 periorbital xanthelasmas) and the results obtained after one treatment with a new generation, ultrapulsed CO2 laser (COHERENT Ultrapulse 5000C, Palo Alto, CA; 250-500 mJ; 600-900 µsec; 10,600 nm). The followup time was 10 months. Results: All lesions could be removed completely with a single laser treatment. As for side effects, only transient pigmental changes (4% hyperpigmentations, 13% hypopigmentations) and no visible scarring was observed. Three patients (13%) developed a recurrence of xanthelasma. Conclusions:The ultrapulsed CO2 laser is an effective and safe therapeutic alternative to the hitherto described approaches.

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