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Pulsed Dye Laser for Port Wine Stains in 974 Children: A 20-Year Study in China
Bingyu Xiu1, Zhe Xu1, Zigang Xu1
1Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, People's Republic of China.
Insights
Pulsed dye laser (PDL) effectively treats pediatric port-wine stains (PWS), with outcomes influenced by patient age, lesion characteristics, and treatment frequency. This laser therapy demonstrates good efficacy and minimal adverse effects in children.
Area of Science:
- Dermatology
- Vascular Lesions
- Pediatric Medicine
Background:
- Port-wine stain (PWS) is a common congenital vascular malformation affecting children.
- PWS can cause significant physical and psychological distress.
- Pulsed dye laser (PDL) is a primary treatment modality, but large-scale pediatric data are limited.
Purpose of the Study:
- To evaluate the efficacy of 595nm PDL in treating pediatric PWS.
- To identify factors affecting treatment outcomes in children.
- To assess the safety and adverse reactions of PDL for pediatric PWS.
Main Methods:
- Retrospective analysis of 974 pediatric patients (under 18) with PWS (Fitzpatrick skin types II-IV).
- Treatment efficacy assessed via standardized pre- and post-treatment photographs using Achauer's criteria.
- Ridit analysis used to determine the influence of gender, age, lesion location, size, and treatment frequency.
Main Results:
- Overall efficacy rate of 65.3% for PDL treatment.
- Higher efficacy observed in females (69.7%) and adolescents (100%).
- Limb lesions (87.5%) and smaller sizes (≤3 cm², 76.8%) showed better response; efficacy increased with treatment sessions.
Conclusions:
- 595nm PDL is an effective treatment for pediatric PWS.
- Treatment outcomes are significantly influenced by patient demographics and lesion characteristics.
- PDL therapy in children is associated with a low incidence of adverse reactions.
Importance:
Port-wine stain (PWS) is a congenital vascular condition involving dilation of skin capillaries and venules, significantly affecting patients' physical and mental health. Pulsed dye laser (PDL) is widely used for PWS treatment; however, large-scale data on pediatric cases remain limited. This retrospective study aims to investigate the efficacy of laser treatment and its related factors in a large sample.
Objective:
To assess the clinical efficacy and adverse reactions of 595nm PDL for treating pediatric PWS and to identify factors influencing treatment outcomes.
Methods:
This retrospective study included 974 pediatric patients with PWS treated at Beijing Children's Hospital from 2003 to 2021. Inclusion criteria required patients to be under 18, with solitary PWS and Fitzpatrick skin types II-IV. Treatment efficacy was evaluated using standardized photographs taken before and after treatment, with outcomes categorized by Achauer's clearance criteria. Ridit analysis assessed the impact of variables such as gender, age, lesion location, and treatment frequency on outcomes.
Results:
The overall efficacy rate was 65.3%, higher in females (69.7%) than males (59.7%). Adolescents had the highest efficacy (100%) due to better compliance. Limb lesions responded best (87.5%), followed by neck (75.0%), trunk (66.7%), and head/face (63.0%). Smaller lesions (≤3 cm²) achieved 76.8% efficacy. Efficacy rose with sessions, reaching 84.0% after three. The mandibular branch (V3) had the highest trigeminal efficacy (68.5%). Adverse reactions (4.31%) included pigmentation changes (2.87%), hypopigmentation (1.03%), and minimal scarring (0.41%).
Conclusion:
The efficacy of 595nm PDL for treating PWS in children is influenced by gender, age, lesion location, size, and the number of treatment sessions. PDL is an effective treatment for pediatric PWS with minimal adverse reactions.
