Premium
Treatment of hypertrophic and resistant port wine stains with a 755 nm laser: A case series of 20 patients
Author(s) -
Izikson Leonid,
Nelson J. Stuart,
Anderson R. Rox
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.20793
Subject(s) - port wine , medicine , port wine stain , laser , dye laser , laser treatment , laser therapy , dermatology , surgery , optics , physics
Background and Objective Port wine stains (PWS) are heterogeneous vascular malformations that can be treated with vascular‐selective pulsed dye lasers (PDL). Hypertrophic PWS, especially in adults, are consistently less responsive to PDL. Furthermore, many PWS that respond well initially to PDL treatment may reach a response plateau, becoming unresponsive to further PDL treatments, a phenomenon termed “treatment resistance.” Based on the theory of selective photothermolysis, vessels in such lesions may also be specifically targeted with a 755 nm laser that has selectivity for deoxyhemoglobin as well as oxyhemoglobin and increased depth of skin penetration. Study Design/Patients and Methods Retrospective case review of 20 patients with either hypertrophic or PDL‐resistant PWS treated with a 755 nm laser alone or in combination with other lasers, including PDL. Results Hypertrophic PWS showed significant lightening after treatment with a 755 nm laser in combination with PDL. Most PDL‐resistant PWS showed moderate improvement after treatment with either a 755 nm laser alone or in combination with another laser, including PDL. Some lesions showed only mild improvement or did not respond. Serious side effects were infrequent. Most commonly encountered complications included pain, edema, bullae, crusting, and rare scarring. Conclusions Alexandrite 755 nm laser can be useful for the treatment of hypertrophic and treatment‐resistant PWS in adult and pediatric patients. Complications are infrequent and predictable. Careful attention to using a fluence at or near the threshold for clinical response with this deeply penetrating laser is essential to prevent serious sequelae. Lasers Surg. Med. 41:427–432, 2009. © 2009 Wiley‐Liss, Inc.