Laser therapy and dermatologic surgery

Numerous advances in surgery and laser therapy applicable to pediatric dermatologic practice have been made. The use of EMLA (eutectic mixture of local anesthetics; Astra USA, Westborough, MA) cream (lidocaine and prilocaine) is invaluable for office dermatologic procedures in children. Despite high patient tolerance, rare adverse events have been described. Newer topical anesthetics with faster onset and greater efficacy are discussed, with special emphasis on their application to the pediatric dermatology patient. Appropriately administered, these newer agents may make certain procedures in children painless or minimally uncomfortable. Newer, improved tissue adhesives are under development and may replace and surpass traditional surface suturing. Limitations to the use of the pulsed dye laser for vascular lesions in children are discussed.