Treatment of poikiloderma of Civatte using a redesigned pulsed dye laser with a 15 mm diameter treatment spot

Abstract

Objectives The pulsed‐dye laser has long been a gold standard in the treatment of poikiloderma of Civatte. Recent advances in pulsed dye laser technology enable output energies 50% higher, enabling beam diameters of up to 15 mm with clinically relevant fluences. In this study, we investigate this new laser for treatment of this condition. Materials and Methods Twenty subjects were enrolled in the study. A total of four treatments were administered at monthly intervals. Blinded assessment of digital, cross‐polarized photographs taken at baseline and two months following the last treatment was performed by blinded physician raters using an 11‐point clearance scale. Subject reported pain scores immediately following treatment and side effects at all visits were recorded by the investigator. Results Seventeen subjects completed the study. Blinded reviewers correctly identified the baseline photo in 48 of 51 cases (94%). All three reviewers mis‐identified the same subjects. The blinded reviewers scored 14 out of the 17 subjects with an improvement greater than 40% and 10 out of the 17 subjects greater than 50%. Average improvement was 49% for all 17 subjects. Side effects were limited to mild edema, and mild to moderate erythema and purpura. Pain scores averaged 3.5 on using an 11‐point scale. Conclusion This study demonstrates the safety and effectiveness of a new pulsed‐dye laser with a 15 mm spot and 50% higher fluences for the treatment of poikiloderma of Civatte. Lasers Surg. Med. 51:54–58, 2019. © 2018 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

Efficacy of 577‐nm Pro‐Yellow laser in port wine stain treatment

“…It is very important to relieve these side effects, especially in the young population. Topical corticosteroids have been used to decrease the inflammatory response and prevent scarring (Bernstein, Schomacker, Paranjape, & Jones, 2019;Gao et al, 2018).…”

“…It is very important to relieve these side effects, especially in the young population. Topical corticosteroids have been used to decrease the inflammatory response and prevent scarring (Bernstein, Schomacker, Paranjape, & Jones, ; Gao et al, ). Nd YAG lasers are also an important treatment option as they can affect the deep vascular structures of PWSs (Wang et al, ).…”

A new treatment option for poikiloderma of Civatte: 577 nm pro‐yellow laser

“…None of the patients developed scarring due to the laser treatment and the treatment response was slower in the neck region compared to the facial region. Hereby, Bernstein et al suggested that PDL was an effective and safe treatment method for poikiloderma of Civatte 9 . However, in another study, it was reported that hypopigmentation and atrophic scars developed in the neck region after treatment with PDL.…”

“…Hereby, Bernstein et al suggested that PDL was an effective and safe treatment method for poikiloderma of Civatte. 9 However, in another study, it was reported that hypopigmentation and atrophic scars developed in the neck region after treatment with PDL. The authors recommended being careful when using PDL in the neck area.…”

Science and peace

“…Ultimately, the best treatments should make people healthier and in turn happier, with improved quality of life. Treatment of Poikiloderma of Civatte using a redesigned pulsed dye laser with a 15 mm diameter treatment spot was evaluated by Bernstein et al, reminding us that we can continue to improve on light‐based technologies, even one of the oldest and best, the pulsed dye laser (https://onlinelibrary.wiley.com/doi/10.1002/lsm.23036). In addition, Aria Vazirnia and Arisa Ortiz from the University of California, San Diego describe treatment of benign pigmented lesions using a novel dermal cooling system which provides precise skin freezing (https://onlinelibrary.wiley.com/doi/10.1002/lsm.23037).…”