Evaluating the Efficacy of Treatment of Resistant Port-Wine Stains With Variable-Pulse 595-nm Pulsed Dye and 532-nm Nd:YAG Lasers

Abstract

In individual patients, it may be effective to treat resistant PWS with the variable-pulse width 595-nm PDL and the 532-nm Nd:YAG laser.

Three-dimensional Monte Carlo model of pulsed-laser treatment of cutaneous vascular lesions

“…39 This is in good agreement with our prediction of H epi = 19.3 J/cm 2 in fair Caucasian skin (at t p = 1 ms). According to our simulation, the above radiant exposure value would cause problems in patients with moderately pigmented Asian skin (H epi = 9.9 J/cm 2 ), but these would probably have been categorized as phototype V and thus not enrolled in the study.…”

“…In another clinical study at 532 nm, 39 radiant exposure of 7 J/cm 2 (t p = 2 ms, d b = 3 mm) was applied with contact cooling of skin, with no adverse effects observed in the patients. Our simulation results indicate H epi = 14.2 J/cm 2 for fair Caucasian and 7.6 J/cm 2 for moderately pigmented Asian skin, respectively.…”

A direct comparison of pulsed dye, alexandrite, KTP and Nd:YAG lasers and IPL in patients with previously treated capillary malformations

“…It does however have relatively high specificity for oxyhaemoglobin absorption. Previous studies using a KTP laser to treat CMs have similarly focused upon patients who have previously been treated with the PDL [7,8]. These have indicated a varying degree of response to treatment, with one study reporting a 14% response rate [7], whilst the other reported a 53% response rate [8].…”

“…However, complete CM clearance rates have remained around 15% despite the use of later generation PDL's with longer wavelengths and deeper penetration [1]. Therefore other laser and non-laser systems have been used in an attempt to improve CM clearance, including intense pulsed light (IPL) [2][3][4][5][6], the KTP laser [7,8], and the long-pulsed Nd:YAG laser [9].…”

Treatment of pulsed dye laser–resistant port wine stain birthmarks

“…However, clinical studies and experience using both approaches either alone or in combination have shown only little further therapeutic benefit. 22 Further treatment with PDL at lower subpurpuric fluences (6-7 mJ/cm 22 ) with no immediate or transiently appearing but rapidly fading purpura, usually combined with slightly longer pulse durations ranging from 3 to 6 milliseconds Using pulse stacking (2-3 consecutive pulses applied immediately after the preceding pulse to the same spot 23 ) may produce further lightening of PWS. The theory is that cumulative gentle heating may produce overall greater capillary heating and, hence, more efficient capillary wall damage than that achievable by a single high-energy short duration purpura-inducing pulse of laser light.…”