Top

Published in:

01-11-2018 | Original Article

Less is more: similar efficacy in three sessions and seven sessions of pulsed dye laser treatment in infantile port-wine stain patients

Authors: Jiafang Zhu, Wenxin Yu, Tianyou Wang, Yijie Chen, Dongze Lyu, Lei Chang, Gang Ma, Xiaoxi Lin

Published in: Lasers in Medical Science | Issue 8/2018

Abstract

Port-wine stains (PWS) affect 0.3 to 0.5% of newborns and pulsed dye laser (PDL) remains the treatment of choice. However, no reliable study regarding the benefits of more frequent has been conducted. We designed the present study to evaluate whether more frequent PDL treatments in infantile patients would achieve further lightening of erythema. We prospectively investigated 20 infants with PWS. Two adjacent sites were both treated for a 12-week duration and randomly allocated to be treated for seven sessions at 2-week intervals or three sessions at 6-week intervals. The efficacy outcome 2 months after the final treatment was determined by visual and chromameter evaluation. Sixteen patients completed the study with a total of 54 treatment sites. Similar results were observed in the two groups. The average blanching rates were 42.93% (SD = 27.92%) and 43.81% (SD = 32.80%) for PDL treatments with seven and three sessions, respectively (p = 0.374). Partial recovery from the laser treatment was more frequently observed and side effects were significantly higher at 2-week follow-ups (p < 0.001), resulting in a total of 3–13 weeks for skin recovery. More frequent PDL treatments do not necessarily increase efficacy in infantile PWS patients. Considering the potential risks and added costs, this practice may not be of benefit. (Clinical trial registration number: ChiCTR-ONC-17010857)

Lanigan SW, Taibjee SM (2004) Recent advances in laser treatment of port-wine stains. Br J Dermatol 151:527–533CrossRef

Nelson JS, Milner TE, Anvari B et al (1996) Dynamic epidermal cooling in conjunction with laser-induced photothermolysis of port wine stain blood vessels. Lasers Surg Med 19:224–229CrossRef

van der Horst CM, Koster PH, de Borgie CA et al (1998) Effect of the timing of treatment of port-wine stains with the flash-lamp-pumped pulsed-dye laser. N Engl J Med 338:1028–1033CrossRef

Reyes BA, Geronemus R (1990) Treatment of port-wine stains during childhood with the flashlamp-pumped pulsed dye laser. J Am Acad Dermatol 23:1142–1148CrossRef

Ashinoff R, Geronemus RG (1991) Flashlamp-pumped pulsed dye laser for port wine stains in infancy: earlier vs. later treatment. J Am Acad Dermatol 24:467–472CrossRef

Morelli JG, Weston WL, Huff JC et al (1995) Initial lesion size as a predictive factor in determining the response of port-wine stains in children treated with the pulsed dye laser. Arch Pediatr Adolesc Med 149:1142–1144CrossRef

Renfro L, Geronemus RG (1993) Anatomical differences of port wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 129:182–188CrossRef

Nguyen CM, Yohn JJ, Huff C et al (1998) Facial port wine stains in childhood: prediction of the rate of improvement as a function of the age of the patient, size and location of the port wine stain and the number of treatments with the pulsed dye (585 nm) laser. Br J Dermatol 138:821–825CrossRef

Kauvar AN, Geronemus RG (1995) Repetitive pulsed dye laser treatments improve persistent port-wine stains. Dermatol Surg 21:515–521PubMed

10.

Jasim ZF, Handley JM (2007) Treatment of pulsed dye laser-resistant port wine stain birthmarks. J Am Acad Dermatol 57(4):677–682CrossRef

11.

Tomson N, Lim SP, Abdullah A et al (2006) The treatment of port-wine stains with the pulsed-dye laser at 2-week and 6-week intervals: a comparative study. Br J Dermatol 154:676–679CrossRef

12.

Anolik R, Newlove T, Weiss ET et al (2012) Investigation into optimal treatment intervals of facial port-wine stains using the pulsed dye laser. J Am Acad Dermatol 67(5):985–990CrossRef

13.

Babilas P, Schreml S, Eames T et al (2010) Split-face comparison of intense pulsed light with short- and long-pulsed dye lasers for the treatment of port-wine stains. Lasers Surg Med 42:720–727CrossRef

14.

Chapas AM, Eickhorst K, Geronemus R (2007) Efficacy of early treatment of facial port wine stains in newborns: a review of 49 cases. Lasers Surg Med 39:563–568CrossRef

15.

Yung A, Sheehan-Dare R (2005) A comparative study of a 595-nm with a 585-nm pulsed dye laser in refractory port wine stains. Br J Dermatol 153:601–606CrossRef

16.

Lanigan SW (1998) Port wine stains unresponsive to pulsed dye laser: explanations and solutions. Br J Dermatol 139:173–177CrossRef

17.

Kono T, Groff WF, Sakurai H (2006) Treatment of port wine stains with the pulse dye laser. Ann Plast Surg 56:460–463CrossRef

18.

Svaasland LO, Aguilar G, Viator JA et al (2004) Increase of dermal blood volume fraction reduces the threshold for laser-induced purpura: implications for port wine stain laser treatment. Lasers Surg Med 34:182–188CrossRef

19.

Altschuler GB, Anderson RR, Manstein D et al (2001) Extended theory of selective photothermolysis. Lasers Surg Med 29:416–432CrossRef

20.

Dover JS (2000) New approaches to laser treatment of vascular lesions. Australas J Dermatol 41:14–18CrossRef

21.

Woo WK, Jasim ZF, Handley JM (2004) Evaluating the efficacy of treatment of resistant port-wine stains with variable-pulse 595-nm pulsed dye and 532-nm Nd:YAG lasers. Dermatol Surg 30:158–162PubMed

22.

Bjerring P, Christiansen K, Troilius A (2003) Intense pulsed light source for the treatment of dye laser resistant port wine stains. J Cosmet Laser Ther 5:7–13PubMed

23.

Evans AV, Robson A, Barlow RJ et al (2005) Treatment of port wine stains with photodynamic therapy using pulsed dye laser as a light source compared with pulsed dye laser alone: a pilot study. Lasers Surg Med 36:266–269CrossRef

24.

Kelly KM, Kimel S, Smith T et al (2004) Combined photodynamic and photothermal-induced injury enhances damage to in vivo model blood vessels. Lasers Surg Med 34:407–413CrossRef

25.

Lin XX, Wang W, Wu SF et al (1997) Treatment of capillary vascular malformation (port wine staina) with photochemotherapy. Plast Reconstr Surg 99:1826–1830CrossRef

26.

Hofer T (2002) Meyerson phenomenon within a nevus flammeus. Dermatology 205(2):180–183CrossRef

27.

Tay YK, Morelli J, Weston WL (1996) Inflammatory nuchal-occipital port-wine stains. J Am Acad Dermatol 35(5 Pt 2):811CrossRef

28.

Shahidullah H, Frieden IJ (1999) Eczema as a complication of pulsed dye laser therapy. Arch Dermatol 135(2):215–216CrossRef

29.

Owens WW 3rd, Lang PG (2004) Herpes simplex infection and colonization with Pseudomonas aeruginosa complicating pulsed-dye laser treatment. Arch Dermatol 140(6):760–761PubMed

30.

Chen T, Frieden IJ (2007) Development of extensive flat warts after pulsed dye laser treatment of a port-wine stain. Dermatol Surg 33(6):734–735PubMed

31.

Hidano A, Purwoko R, Jitsukawa K (1986) Statistical survey of skin changes in Japanese neonates. Pediatr Dermatol 3:140–144CrossRef

32.

Tan OT, Kerschmann R, Parrish JA (1984) The effect of epidermal pigmentation on selective vascular effects of pulsed laser. Lasers Surg Med 4:365–374CrossRef

33.

Tong AKF, Tan OT, Boll J et al (1987) Ultrastructure: effects of melanin pigment on target specificity using a pulsed dye laser (577 nm). J Invest Dermatol 88:747–752CrossRef

34.

Yu W, Ma G, Qiu Y et al (2015) Prospective comparison treatment of 595 nm pulsed dye lasers (PDL) for virgin port-wine stain (PWS). Br J Dermatol 172(3):684–691CrossRef

Title: Less is more: similar efficacy in three sessions and seven sessions of pulsed dye laser treatment in infantile port-wine stain patients
Authors: Jiafang Zhu
Wenxin Yu
Tianyou Wang
Yijie Chen
Dongze Lyu
Lei Chang
Gang Ma
Xiaoxi Lin
Publication date: 01-11-2018
Publisher: Springer London
Published in: Lasers in Medical Science / Issue 8/2018
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-018-2525-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Less is more: similar efficacy in three sessions and seven sessions of pulsed dye laser treatment in infantile port-wine stain patients

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2018

Treatment of mucositis with combined 660- and 808-nm-wavelength low-level laser therapy reduced mucositis grade, pain, and use of analgesics: a parallel, single-blind, two-arm controlled study

Green Light photoselective vaporization of the prostate: a safe and effective treatment for elderly high-risk benign prostate hyperplasia patients with gland over 80 ml

Laser pulpotomy—an effective alternative to conventional techniques—a systematic review of literature and meta-analysis

Determining the optimal parameters of 420-nm intense pulsed light on Trichophyton rubrum growth in vitro

Appropriate laser wavelengths for photodynamic therapy with methylene blue

In vitro impact of laser irradiation on platelet aggregation