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Port wine stain progression: A potential consequence of delayed and inadequate treatment?
Author(s) -
Minkis Kira,
Geronemus Roy G.,
Hale Elizabeth K.
Publication year - 2009
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/lsm.20788
Subject(s) - port wine stain , medicine , port wine , laser treatment , muscle hypertrophy , stain , dye laser , surgery , laser therapy , dermatology , laser , cardiology , pathology , optics , staining , physics
Background and Objectives Port wine stains are congenital low‐flow vascular malformations of the skin. Unlike hemangiomas, PWS do not involute with time, but rather if left untreated can hypertrophy and develop nodularity. Laser therapy of PWS particularly with pulsed‐dye lasers, is a safe, well‐established treatment that is successful in the majority of patients, especially for younger patients. Patients that fail to receive treatment early in life may subsequent develop lesions more likely to progress. Study Design/Patients and Methods A case report and review of the literature are presented. We report a 43 year‐old man born with a port‐wine stain on the right side of his face that extended in the V2 distribution on his face. He had undergone several sessions with a pulsed‐dye laser, the sequential dual‐wavelength (595 nm and 1064 nm) laser and a CO 2 resurfacing laser from the age of 26 but failed to follow through with a sufficient number of treatments to prevent hypertrophy. Results Due to an insufficient number and interval of treatments (with only 7 treatments over 16 years starting at age 26) with the various lasers, the patient's port wine stain continued to progress in color and development of nodularity. Conclusions Patients born with port wine stains should have early laser treatment to achieve optimal results. Delay in treatment, as in this patient until age 26, may result in hard to treat PWS that can continue to progress in nodularity. This case illustrates the hypertrophy and nodularity that can occur due to progression of a PWS with failure to follow through with sufficient number of laser treatments. Lasers Surg. Med. 41:423–426, 2009. © 2009 Wiley‐Liss, Inc.

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