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Clinical Outcomes of Small Infantile Hemangiomas Treated With Pulsed Dye Laser
Misako Nakazono1, Shintaro Kagimoto1, Tomoyuki Koike1
1Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.
Insights
Pulsed dye laser (PDL) treatment for small infantile hemangiomas (IHs) can lead to significant cosmetic issues, particularly with combined-type lesions. These residual skin changes, including anetoderma, highlight the need for careful consideration of PDL for all IH types.
Area of Science:
- Dermatology
- Pediatric Medicine
- Laser Therapy
Background:
- Infantile hemangioma (IH) frequently causes cosmetic disfigurement.
- While propranolol is recommended for large, high-risk IH, management for small, low-risk lesions remains unclear.
- Pulsed dye laser (PDL) is a common treatment for small IH, but its outcomes are not well-established.
Purpose of the Study:
- To investigate the clinical outcomes of PDL treatment in small infantile hemangioma lesions.
- To evaluate residual skin changes following PDL therapy for small IH.
Main Methods:
- Retrospective review of 53 cases with 58 small IHs treated solely with PDL.
- Analysis of IH characteristics and post-treatment residual skin changes.
Main Results:
- 81.0% of lesions were superficial IH, 19.0% were combined-type.
- 77.6% of lesions showed residual skin changes post-PDL, including anetoderma (53.5%) and telangiectasia/erythema (43.1%).
- Anetoderma and fibrofatty tissue were significantly more common in combined-type IH compared to superficial IH.
Conclusions:
- PDL treatment for small infantile hemangiomas can result in notable cosmetic problems.
- Combined-type small IH lesions are particularly prone to developing residual skin changes after PDL therapy.
Background:
Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions.
Objective:
To investigate clinical outcomes of PDL in small IH lesions.
Patients And Methods:
Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated.
Results:
Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group ( p = .036 and .033, respectively).
Conclusion:
Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.
