Treatment of recalcitrant port-wine stains (PWS) using a combined pulsed dye laser (PDL) and radiofrequency (RF) energy device

Bae, Yoon-Soo Cindy; Alabdulrazzaq, Hamad; Brauer, Jeremy A.; Geronemus, Roy G.

doi:10.1016/j.jaad.2016.03.004

Cited by 21 publications

(21 citation statements)

References 10 publications

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“…of studies was randomized (i.e., randomization of treatments to different patients or to different sites within one patient and/or PWS) [11,31,36,39,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]61,62,81,92,103]. Of the uncontrolled (noncomparative) studies (N = 42/75 [63][64][65][66][67][68][69][71][72][73][74][75][76][77][78][79][80][82][83][84][85][86][87]…”

Section: Plos Onementioning

confidence: 99%

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

et al. 2020

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Background Valid and reliable outcome measures are needed to determine and compare treatment results of port wine stain (PWS) studies. Besides, uniformity in outcome measures is crucial to enable inter-study comparisons and meta-analyses. This study aimed to assess the heterogeneity in reported PWS outcome measures by mapping the (clinical) outcome measures currently used in prospective PWS studies. Methods OVID MEDLINE, OVID Embase, and CENTRAL were searched for prospective PWS studies published from 2005 to May 2020. Interventional studies with a clinical efficacy assessment were included. Two reviewers independently evaluated methodological quality using a modified Downs and Black checklist. Results In total, 85 studies comprising 3,310 patients were included in which 94 clinician/observerreported clinical efficacy assessments had been performed using 46 different scoring systems. Eighty-one-studies employed a global assessment of PWS appearance/improvement, of which-82% was expressed as percentage improvement and categorized in 26 different scoring systems. A wide variety of other global and multi-item scoring systems was identified. As a result of outcome heterogeneity and insufficient data reporting, only 44% of studies could be directly compared. A minority of studies included patient-reported or objective outcomes. Thirteen studies of good quality were found.

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Section: Plos Onementioning

confidence: 99%

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

et al. 2020

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“…Regarding the RF component of the handpiece, we did not observe an advantage of adding it to “preheat” the dermis. In contrast, another PDL study [10] showed a tendency toward improved clearance of port‐wine stain with RF. Also, some utility of using the RF component was shown in a recent study using a home device for hair removal utilizing IPL and RF [11].…”

Section: Discussionmentioning

confidence: 89%

Enhanced Pulsed Dye Laser for Facial Rejuvenation

et al. 2020

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Background and Objectives To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial‐dyschromia. Study Design/Materials and Methods Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5–12 mm with fluences ranging from 8 to 18 J/cm2. Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm2). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre‐auricular area) for addition of RF energy just before the pulse (40–70 J/cm3) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow‐up visits 1 and 3 months after the final treatment. Results Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50–75% clearance, and 23% of lesions had 76–100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively. Conclusion An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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“…A recently reported method describes using a fractionation of high‐fluence 595 nm PDL for rosacea with greatly efficacious results and without purpura . Additionally, the combination of optical and radiofrequency (RF) energies has been introduced in the last few years in some platforms for the treatment of vascular lesions . In fact, RF alone, without any light‐energy, has newly been shown to be as effective as PDL in the treatment of rosacea in a small study .…”

Section: Futurementioning

confidence: 99%

“…55 Additionally, the combination of optical and radiofrequency (RF) energies has been introduced in the last few years in some platforms for the treatment of vascular lesions. 56,57 In fact, RF alone, without any light-energy, has newly been shown to be as effective as PDL in the treatment of rosacea in a small study. 58 In the past more than five decades, the field of laser and other light-based devices has produced many revolutionary treatment options for cutaneous vascular lesions, and yet this still is a field of exciting growth for physicians and their patients.…”

Section: Futurementioning

confidence: 99%

Light‐based devices in the treatment of cutaneous vascular lesions: An updated review

Garden

Goldberg

2017

J of Cosmetic Dermatology

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Treatment of recalcitrant port-wine stains (PWS) using a combined pulsed dye laser (PDL) and radiofrequency (RF) energy device

Cited by 21 publications

References 10 publications

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review

Enhanced Pulsed Dye Laser for Facial Rejuvenation

Light‐based devices in the treatment of cutaneous vascular lesions: An updated review

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