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[Treatment of pediatric hemangiomas with the flashlamp-pumped pulsed dye laser]
U Hohenleutner1, W Bäumler, S Karrer
1Klinik und Poliklinik für Dermatologie, Klinikum der Unversität, Regensburg.
Insights
Flashlamp-pumped pulsed dye laser (FPDL) therapy effectively treats infantile hemangiomas, especially when initiated early. Repeated treatments improve outcomes for superficial and nodular lesions, offering a safe option for newborns.
Area of Science:
- Dermatology
- Pediatric Medicine
- Laser Therapy
Context:
- Infantile hemangiomas are common vascular tumors in children.
- Treatment options for hemangiomas vary in efficacy and side effect profiles.
- Pulsed dye laser therapy has emerged as a significant treatment modality.
Purpose:
- To evaluate the efficacy of flashlamp-pumped pulsed dye laser (FPDL) in treating infantile hemangiomas.
- To assess treatment outcomes based on hemangioma classification and number of sessions.
- To determine the suitability of FPDL therapy for different types of hemangiomas, including in newborns.
Summary:
- A study treated 177 hemangiomas in 166 infants and children using FPDL (585 nm).
- Good clearance (>75%) was achieved in 56% of initial lesions and 36% of nodular lesions after one session.
- Repeated sessions improved outcomes, with complete resolution rates of 44% (initial), 42% (superficial), and 16% (nodular). Compound lesions showed limited response due to shallow laser penetration.
- Early FPDL therapy is recommended for most initial and rapidly growing hemangiomas due to its speed, minimal side effects, and applicability in newborns.
Impact:
- FPDL therapy demonstrates significant efficacy in treating various types of infantile hemangiomas.
- Early intervention with FPDL can lead to better treatment outcomes and potentially prevent complications.
- The study supports FPDL as a safe and effective therapeutic option for infantile hemangiomas, even in the neonatal period.
Abstract:
We treated 166 infants and children with 177 hemangiomas with the flashlamp-pumped pulsed dye laser (FPDL, 585 nm, 450 microseconds, 5 mm phi). The hemangiomas were classified as initial, superficial, cutaneous-nodular, and compound (cutaneous-subcutaneous) lesions according to the clinical involvement. After one treatment (n = 124), good results ( > 75% clearance) were obtained in 56% of initial and in 36% of the nodular lesions. With repeated treatment sessions (n = 82), good results were achieved in 63% of the initial, in 67% of the superficial and in 70% of the nodular angiomas. Complete resolution requiring one or more treatment sessions was reached in 44% of the initial, in 42% of the superficial and in 16% of the nodular lesions. In compound lesions, only the cutaneous part responds to treatment owing to the limited penetration depth of the laser light. In our opinion, early FPDL therapy of most initial and/or rapidly growing hemangiomas should be recommended especially since this therapy is fast, has few side effects and can even be used in newborns.