Treatment of port-wine stains (capillary malformation) with the flashlamp-pumped pulsed dye laser
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M P Goldman1, R E Fitzpatrick, J Ruiz-Esparza
1Dermatology Associates of San Diego County, Inc., Encinitas, California 92024.
Insights
The flashlamp-pumped pulsed dye laser effectively treats pediatric port-wine stains, with younger children showing better clearance. This laser therapy offers a safe and efficient option for vascular malformations.
Area of Science:
- Dermatology
- Pediatric Vascular Anomalies
Background:
- Port-wine stains are common congenital vascular malformations.
- Treatment options for pediatric port-wine stains have evolved with laser technology.
Purpose of the Study:
- To evaluate the safety and efficacy of the flashlamp-pumped pulsed dye laser (PDL) at 585 nm for treating port-wine stain capillary malformations in children.
Main Methods:
- Forty-three children with 49 port-wine stains were treated with a 585 nm PDL.
- Patient ages ranged from 2 weeks to 14 years.
- Treatment outcomes were assessed based on lesion clearance and adverse events.
Main Results:
- 16% of patients achieved >95% port-wine stain resolution after an average of 4.8 treatments.
- Lesions not fully cleared showed an average improvement of 69% with 3.7 treatments.
- Younger children (<4 years) had higher clearance rates (20% vs 12%) and required fewer treatments (3.8 vs 6.5).
- No scarring or persistent pigmentary changes were observed.
- Facial and truncal lesions responded better than those on extremities.
Conclusions:
- The 585 nm flashlamp-pumped pulsed dye laser is a safe and effective treatment for pediatric port-wine stains.
- Early treatment in younger children yields superior outcomes.
- PDL therapy provides significant improvement for residual lesions.
Abstract:
Forty-three children with 49 separate port-wine stain vascular malformations were treated with the flashlamp-pumped pulsed dye laser at 585 nm. The patients ranged in age from 2 weeks to 14 years. Overall, 16% of patients had more than 95% resolution of their port-wine stains after an average of 4.8 (1 to 11) treatments. There was an average improvement of 69% in those lesions not clearing completely (average of 3.7 treatments). Lesions in patients less than 4 years of age were almost twice as likely to clear than were those in older children (20% vs 12%), and in fewer treatments (3.8 vs 6.5). An approximate 50% clearing was obtained with one treatment. Subsequent treatments resulted in an additional 10% clearing. There were no episodes of scarring or persistent pigmentary changes in any of the patients. Lesions on the hand and arm responded less well than lesions on the face, neck, and torso. The flashlamp-pumped pulsed dye laser has proved to be a safe and effective treatment modality for port-wine stain capillary malformations in infants and children.