Port-wine Stain-a Surgical and Psychological Problem

Malm, Mats; Carlberg, Margareta

doi:10.1097/00000637-198806000-00002

Cited by 85 publications

(31 citation statements)

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“…Our data correspond well with the results indicated by earlier studies, showing a considerable emotional impact of a PWS. 6,7,13 Data from patients in 71 questionnaires emphasized that over 50% of the patients felt embarrassed and depressed because of their birthmark. Fortyone per cent felt that people avoided looking at them.…”

Section: Discussionmentioning

confidence: 99%

“…The patients were asked if their life would change if they could get rid of their birthmark without a scar. These areas of enquiry were chosen from earlier studies 6,7 and from our experience with this group of patients.…”

Section: Patientsmentioning

confidence: 99%

“…6 Also, patients with large PWS were shown to have reality problems in common. 7 The treatment of choice today is recognized to be the flashlamp pulsed dye laser (PDL), and many studies have shown its effectiveness both in the treatment of grown-ups 8 and in the treatment of children. 9 Several PDL studies have been carried out with infants and children, and their results have been effective and the procedures safe.…”

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confidence: 99%

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Potential psychological benefits from early treatment of port-wine stains in children

1998

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There is a commonly held conception among referring doctors that very small children with congenital capillary malformations, so-called port-wine stains (PWS), should not be treated until they are older. Our experience leads us to believe that the flashlamp pulsed dye laser is a safe and effective treatment even for infants. We have not encountered any persistent pigmentation changes, post-treatment scarring or other adverse effects. It is important to quantify the psychological disabilities associated with this disorder to assess the need for and the benefits of treatment. Questionnaires were distributed to 259 patients and their families who visited our clinic because of their PWS. Patients who were on the waiting list for laser treatment, undergoing treatment or had completed their treatment received different questionnaires. The response rate was 89%. High emotional distress was encountered. During the age period 10-20 years, 73% (125 patients) were most disturbed by their PWS. That the PWS influenced their life negatively was experienced by 75% (171 patients), and 62% (106 patients) were convinced that their life would change radically if their PWS could be eliminated. Suffering from low self-esteem (in comparison with the same age group) was reported by 47% (87% patients). The PWS made their school life and education more difficult according to 28% (51 patients) of the sample. Of the families of patients, 76% (106 relatives) considered the patient to be negatively affected in some way by the PWS. After the laser treatment, all of these distress parameters were significantly relieved, together with a need to cover their PWS, their fear of going into conflict or quarrels, their social relationships, problems with the opposite sex, rage attacks, depressions and abnormal reactions from their peers. We believe there is potential psychological benefit in starting the treatments of PWS (including non-facial) at as early an age as possible.

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confidence: 99%

Section: Patientsmentioning

confidence: 99%

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Potential psychological benefits from early treatment of port-wine stains in children

1998

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“…1 PWSs may be located anywhere on the body, but are commonly found on the face and neck, where they may have serious psychological consequences. [2][3][4] Patients are often perceived by others as "marked," which may adversely affect personality development. Over time, these lesions may hypertrophy and patients may experience local bleeding.…”

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confidence: 99%

Treatment of Port-Wine Stain Birthmarks Using the 1.5-msec Pulsed Dye Laser at High Fluences in Conjunction with Cryogen Spray Cooling

Kelly

Nanda

Nelson

2002

Dermatologic Surgery

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background. The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy. objective. To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling. methods. Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm 2 . Before and after treatment photographs were compared on a blinded basis.

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“…1 Their psychologic impact when affecting exposed areas can be devastating. 2 The shortpulse 0.45-ms, 585-nm pulsed dye laser (PDL) has been used for over 15 years in the treatment of PWS. Despite initial anecdotal reports of 100% clearance, experience has shown that very few lesions (less than 25%) clear completely, whereas up to 75% can be substantially improved with more than 50% fading.…”

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confidence: 99%

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

Woo

Jasim

Handley

2004

Dermatologic Surgery

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BACKGROUND. Some port wine stains (PWSs), despite multiple treatments with the 585-nm 0.45-ms pulsed dye laser (PDL), fail to improve substantially. OBJECTIVE. To determine the efficacy and tolerability of variable pulse width 595-nm PDL and 532-nm Nd:YAG laser in the treatment of resistant PWS. METHODS. Twenty-two patients whose PWS failed to achieve more than 75% lightening after more than 15 treatments with the 585-nm 0.45-ms PDL were recruited. A homogenous patch of PWS was divided into five areas. Area 1 (control area) was treated with 585-nm, 0.45-ms PDL (fluence 7.5 J/cm 2 ). Areas 2 and 3 were treated with 595-nm PDL at fluence 15 J/cm 2 (with cryogen spray cooling) and pulse durations of 1.5 and 10 ms, respectively. Areas 4 and 5 were treated with a 532-nm Nd:YAG laser at 2 ms, 7 J/cm 2 and 10 ms, 16 J/cm 2 , respectively (with a contact cooling tip). The response was assessed by photographic evaluation. RESULTS. Three patients had further lightening in area 2, and two patients had further lightening in area 3. Each of three patients had further lightening in areas 4 and 5, respectively. One patient had further lightening in the control area. CONCLUSION. 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.

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Port-wine Stain-a Surgical and Psychological Problem

Cited by 85 publications

References 0 publications

Potential psychological benefits from early treatment of port-wine stains in children

Potential psychological benefits from early treatment of port-wine stains in children

Treatment of Port-Wine Stain Birthmarks Using the 1.5-msec Pulsed Dye Laser at High Fluences in Conjunction with Cryogen Spray Cooling

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

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