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Published on: June 15, 2020
Treating vascular lesions
Susanne Astner1, R Rox Anderson
1Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Insights
Laser therapy effectively treats acquired and congenital vascular lesions using selective photothermolysis. This review differentiates lesion types, guiding treatment choices for better outcomes in vascular lesion management.
Area of Science:
- Dermatology
- Laser Medicine
- Cutaneous Surgery
Background:
- Vascular lesions, both acquired and congenital, are common conditions requiring treatment.
- Laser treatment, based on selective photothermolysis, is a primary modality for vascular lesions.
- Existing laser treatments have limitations, necessitating refined approaches.
Purpose of the Study:
- To differentiate between acquired and congenital vascular lesions.
- To categorize vascular lesions based on treatment ease and difficulty.
- To discuss various laser treatment modalities and their endpoints.
Main Methods:
- Review of established laser treatment principles for vascular lesions.
- Analysis of different laser wavelengths (green, yellow, near-infrared) and light sources.
- Classification of vascular lesions for targeted therapeutic strategies.
Main Results:
- Acquired and congenital vascular lesions require distinct treatment considerations.
- A proposed classification system aids in selecting appropriate laser therapies.
- Understanding specific lesion endpoints is crucial for successful treatment.
Conclusions:
- Laser therapy remains the gold standard for vascular lesion treatment.
- Stratifying lesions into easily and difficult-to-treat categories improves therapeutic planning.
- Tailoring treatment modalities to individual vascular lesion characteristics is key.
Abstract:
The treatment of acquired vascular lesions is one of the most commonly requested and performed cutaneous laser procedures. Furthermore, every year, 40,000 children are born in the United States each with congenital vascular lesions and malformations. Laser treatment of vascular lesion is based on the principle of selective photothermolysis, conceived in the 1980s. A variety of different lasers and light sources have since been used in the treatment of vascular lesions: lasers with wavelengths between green and yellow, near infrared lasers, and broadband light sources. Despite limitations, this remains the treatment of choice today. This publication addresses acquired and congenital vascular lesions as different entities and proposes a separation of vascular lesions into those that can easily be treated from those where clearance is difficult. Different treatment modalities and the various endpoints of individual vascular lesions will be discussed.
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