The Treatment of Port-wine Stains by the Pulsed Dye Laser

Abstract

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)

Effectiveness of the 585nm flashlamp-pulsed tunable dye laser (PTDL) for treatment of plantar verrucae

“…Several articles studying the use of the PTDL in the treatment of various dermatological lesions have reported minimal to no side effects, such as scarring, bleeding, pain, abscess formation, and infection [7,8,[13][14][15][16]. This aspect of the PTDL was confirmed during this investigation, thereby making it a potentially more attractive mode of treatment for warts.…”

Granuloma pyogenicum as a Complication of FlashIamp-Pumped Pulsed Dye Laser

“…In a single case, a hypertrophic scar was reported by Swinehart [13]. Garden et al [6] reported the development of a 3 x 2 mm pyogenic granuloma in the area of laser therapy after 6 weeks of treatment of a PWS.…”

“…Following treatment with the FPDL, superficial blood vessels demonstrate agglutinated blood cells, fibrin and platelet thrombi confined to the papillary and reticular dermis with little or no damage to the sur rounding dermis, epidermis and adnexal structures [3]. These advantages of the FPDL have been confirmed by clinical results in numerous studies in the treatment of portwine stains (PWS), telangiectases and hemangiomas in children [4][5][6][7][8][9][10].…”

“…1994 treated area but normal skin color usually returns within 6 months of the final treatment [5]. Hypopigmentation occur ring after high energy doses was reported [6]. Some atrophy or slight skin depression has been reported but this is usu ally secondary to using high energy levels or applying repeated pulses of laser energy to the same spot [5,11,12].…”

Copper bromide laser treatment of facial telangiectasia: Results of patients treated over five years

“…If a major proportion of the endothelial surface remains viable after laser irradiation, recanalisation is likely to occur. This may be an explanation for the observed reduced efficacy of the pulsed dye laser on the higher grades of PWS, i.e., those composed of significantly larger vessels [22]. A laser that can deliver yellow light for a period of time longer than the thermal relaxation time of the vessels (Table 1), but a time still short enough that thermal damage to nonvascular structures will be minimal, may offer considerable advantages for treating cutaneous lesions composed of larger vessels.…”