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Leg telangiectasia treatment with a 1.5 ms pulsed dye laser, ice cube cooling of the skin and 595 vs 600 nm: Preliminary results
Author(s) -
Hohenleutner Ulrich,
Walther Thomas,
Wenig Matthias,
Bäumler Wolfgang,
Landthaler Michael
Publication year - 1998
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1998)23:2<72::aid-lsm4>3.0.co;2-s
Subject(s) - telangiectasia , materials science , biomedical engineering , laser , medicine , dermatology , nuclear medicine , optics , physics
Background and Objective: Preliminary results indicate that pulsed dye lasers (PDL) with 1.5 ms pulsewidth and 595 nm wavelength are effective in the treatment of leg telangiectasia. The aim of this study was to evaluate if the clinical results could be improved by a) an effective skin cooling with ice cubes and b) the longer wavelength of 600 nm. Study Design/Materials and Methods: In 87 patients with vessels up to 1 mm in diameter, 257 single test treatments were performed using wavelengths of 595 and 600 nm, fluences of 16, 18, and 20 J/cm 2 , a 1.5 ms pulse duration, and an elliptical spot of 2 × 7 mm. In 7 patients, the skin surface temperature curve was measured after cooling with ice cubes vs hydrogel dressings, and spot geometry and fluence were investigated with and without the gel dressing. Results Vessel clearance was evaluated 6–8 weeks after treatment. 20 J/cm 2 were most effective (80% clearance >50%), and 18 J/cm 2 were more effective than 16 J/cm 2 (66.2 vs 52.5% clearance >50%). There was a tendency towards better results with 595 nm, but the differences were not significant. Vessels with a diameter <0.5 mm cleared significantly better than those with 0.5–1 mm (69.1 vs 31.9% clearance >50%). Hypo‐ and hyperpigmentation were seen in 32% of the patients. Cooling with ice cubes proved to be far more effective than with hydrogel dressings (temperature decrease approx 15 vs 5°C). Additionally, the gel dressing caused an energy loss of approx 35% and an irregular spot geometry as shown on burn paper. Conclusions Treatment of leg telangiectasia with the 1.5 ms‐PDL is safe and effective, especially in vessels smaller than 0.5 mm in diameter; 595 nm and 18 J/cm 2 seem to be somewhat more effective as 600 nm and 16 J/cm 2 ; and 20 J/cm 2 are even more effective, but persistent hyperpigmentation cannot yet be excluded due to insufficient follow‐up time. Cooling with ice cubes is more effective and less expensive than gel dressings, and the short term clinical results are equivalent, even if the frequency of transient pigmentary changes is increased. Lasers Surg. Med. 23:72–78, 1998. © 1998 Wiley‐Liss, Inc.