Treatment of port-wine stains during childhood with the flashlamp-pumped pulsed dye laser

Reyes, Blas A.; Geronemus, Roy G.

doi:10.1016/0190-9622(90)70348-l

Cited by 228 publications

(111 citation statements)

References 41 publications

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“…They also contrast with the responses seen using PDL in treating PWS in infants. Although atrophic scarring can occur as a sequelae of PDL for PWS, to our knowledge, severe ulceration rarely, if ever, does so [1][2][3][4]26,27].…”

Section: Discussionmentioning

confidence: 99%

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Complications following pulsed dye laser treatment of superficial hemangiomas

et al. 2006

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Background and ObjectivePulsed dye laser (PDL) has been reported to be safe and effective in the management of superficial hemangiomas of infancy. We report 12 patients with hemangiomas with complications following PDL.Study Design/Materials and MethodsRecords of patients with hemangiomas and a known adverse outcome following PDL were reviewed.ResultsAll were treated early (age range: 5 days to 4 months), and all hemangiomas were facial with a superficial component. Eleven were treated with a 585 nm wavelength, fluence range of 4.7–7 J/cm2, without dynamic cooling. One patient received 7–12 J/cm2 utilizing a 595 nm wavelength with dynamic cooling. In eight cases, treatment led to severe ulceration with subsequent pain, scarring, and in one instance, life‐threatening hemorrhage. In four, permanent atrophic scarring was noted without ulceration.ConclusionsPDL treatment of superficial hemangiomas may rarely lead to significant complications including atrophic scarring and severe ulceration. Lasers Surg. Med. 38:116–123, 2006. © 2006 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

“…It has become a widely accepted treatment for port wine stains (PWS), and is considered a safe and effective treatment, even in very young children [1][2][3][4][5][6]. Many reports have also noted success using PDL in the treatment of hemangiomas [1,[7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Complications following pulsed dye laser treatment of superficial hemangiomas

et al. 2006

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“…7,12 However, half of the children overall achieve about 75% blanching after 2 to 3 PDL treatments. 2,6 The incidence of adverse effects is generally considered low for PDL treatment of patients with PWSs. 13 Nevertheless, it has been suggested recently that the incidence may be higher than previously stated in the literature.…”

Section: Discussionmentioning

confidence: 99%

Changes in Skin Redness, Pigmentation, Echostructure, Thickness, and Surface Contour After 1 Pulsed Dye Laser Treatment of Port-wine Stains in Children

Hædersdal¹,

Efsen²,

Gniadecka³

et al. 1998

Arch Dermatol

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Background:The pulsed dye laser is the treatment of choice for children with port-wine stains (PWSs). Evaluation of treatment outcome and adverse effects is traditionally based on subjective clinical scoring systems. We intend to objectify treatment results and adverse reactions after 1 treatment with the pulsed dye laser.Design: A before-and-after trial using skin reflectance to detect changes in skin redness and pigmentation, ultrasonography to evaluate changes in echostructure and skin thickness, and 3-dimensional surface contour analysis to detect changes in surface texture.Patients: Twelve children with PWSs.Setting: A university dermatological department. Results:The skin reflectance-determined change in skin redness correlated with the clinical response (r=0.46, PϽ.002). The percentage of reflectance-determined lightening was equal for pink, red, and dark red PWSs (median, 42.9%). Skin pigmentation increased after laser treat-ment (PϽ.007). Ultrasonography revealed lower dermal echogenicity of preoperative PWSs than of postoperative PWSs (PϽ.007) and healthy skin (PϽ.001). An increase in echogenicity reflected a decrease in the dermal water (blood) content. Variations were found in the dermal localization of the PWS. Skin thickness was significantly higher in the PWS before treatment than after (PϽ.001). The preoperative lesional thickness correlated inversely with the ultrasound-assessed treatment response (r=0.35, PϽ.04). The surface contour parameters decreased significantly after laser treatment, indicating a flattening of the skin surface. The contour changes correlated positively with treatment response. By clinical evaluation, no hypopigmentation or texture changes were detected. Conclusion:The evaluation of treatment outcome and adverse effects is refined by the use of skin reflectance, ultrasonographic, and surface contour analysis.

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“…It is well established as the most effective and safest treatment for port-wine stains in children [2][3][4]. Although many reports advocate early treatment of hemangiomas to stop the growth and/or induce regression of lesions with the intention to prevent complications [5][6][7][8][9], the treatment of hemangiomas is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Comparison study of a traditional pulsed dye laser versus a long‐pulsed dye laser in the treatment of early childhood hemangiomas

et al. 2005

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Background and Objective: The role of pulsed dye laser (PDL) in the treatment of childhood hemangiomas is still controversial because of the inherent characteristics of hemangiomas as well as the side effects of the PDL. Recently, the long pulsed dye laser (LPDL) with cryogen spray cooling (CSC) has been found relatively more effective and safer than the PDL in the treatment of portwine stains and telangiectasia. This study was designed to compare the efficacy and complication rate of PDL versus LPDL for treating childhood hemangiomas. Study Design/Materials and Methods: We did a prospective, randomized, controlled trial in which we enrolled 52 Asian infants, aged 1-3 months, with early hemangiomas. These infants were assigned to PDL treatment (n ¼ 26) or LPDL treatment (n ¼ 26) and followed to age 1 year. A PDL with a wavelength of 585 nm and spot size of 7 mm and a LPDL with a wavelength of 595 nm and spot size of 7 mm were used. Each patient in the PDL group was treated with energy fluence between 6 and 7 J/cm 2 and a pulse duration of 0.45 milliseconds without epidermal cooling. Each patient in the LPDL group was treated with energy fluence between 9 and 15 J/cm 2 and a pulse duration of 10-20 milliseconds, utilizing CSC to protect the epidermis. Each group was treated at 4-week intervals until the lesion cleared. When each patient reached an age of 1 year, outcome measures such as clearance rate, time period of maximum proliferation, and complications were assessed. Results: The number of children whose lesions showed complete clearance or minimal residual signs at 1 year of age was 14 (54%) in the PDL group and 17 (65%) in the LPDL group (P ¼ 0.397). Compared with the LPDL, PDL treated children had more hypopigmentation (3, 12% vs. 8, 31%; P ¼ 0.001), more hyperpigmentation (2, 8% vs. 4, 15%; P ¼ 0.005), and more textural changes (1, 4% vs. 6, 23%; P ¼ 0.001). The average time period of maximum proliferation in the LPDL group was significantly shorter than that of the PDL group (106 days vs. 177 days; P ¼ 0.01). Conclusion: Early treatment of childhood hemangiomas with the LPDL is safer and more effective than the PDL.

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Treatment of port-wine stains during childhood with the flashlamp-pumped pulsed dye laser

Cited by 228 publications

References 41 publications

Complications following pulsed dye laser treatment of superficial hemangiomas

Complications following pulsed dye laser treatment of superficial hemangiomas

Changes in Skin Redness, Pigmentation, Echostructure, Thickness, and Surface Contour After 1 Pulsed Dye Laser Treatment of Port-wine Stains in Children

Comparison study of a traditional pulsed dye laser versus a long‐pulsed dye laser in the treatment of early childhood hemangiomas

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