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Efficacy of pulsed dye laser treatment of port wine stain malformations of the lower limb
Author(s) -
Sommer S.,
Seukeran D.C.,
SheehanDare R.A.
Publication year - 2003
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.2003.05467.x
Subject(s) - medicine , port wine stain , hyperpigmentation , hypopigmentation , adverse effect , dermatology , lower limb , retrospective cohort study , surgery , laser , physics , optics
Summary Background There is relatively little information about treatment of port wine stains (PWS) of the lower limb. Few studies have specifically addressed the efficacy of pulsed dye laser (PDL) treatment of a PWS on the lower limb and there is no information on the relative efficacy at different sites on the lower limb. It has been suggested that treatment is not as successful when compared with the face and postinflammatory hyperpigmentation has been reported to be a significant problem. Objectives To review retrospectively patients who attended for PDL treatment of PWS affecting the lower limb and assess the efficacy and adverse effects with particular reference to skin site. Methods A retrospective review was carried out of patients attending the Leeds Dermatology Laser Centre for treatment of a PWS on the lower limb with a 585‐nm PDL. Results A total of 52 sites in 39 patients were treated: 17 on the thigh, 31 on the lower leg and four on the foot. The mean number of sessions per patient was 14, with an excellent outcome in seven treatment sites (13·5%), good in 13 (25%), moderate in 21 (40·4%) and poor outcome in 11 (21·1%). Patients were generally pleased with their results with a mean improvement of 7 on a scale of 0–10. Perifollicular persistence of the PWS was observed in six sites (11·5%). Adverse effects occurred in 36 patients (92·3%), most commonly hyperpigmentation (87%). Six patients (15·4%) developed atrophic scarring and four (10·3%) hypopigmentation. Atrophie blanche‐like changes were seen in four patients on the lower leg. Hypertrophic scarring was not seen. Conclusions Although physician‐assessed good or excellent responses of 38·5% are lower than frequently reported for other skin sites and adverse effects may be more frequent, patient satisfaction with treatment was generally high. Patients with PWS on the lower limb merit a trial of PDL treatment.