Alexandrite Laser for the Treatment of Resistant and Hypertrophic Port Wine Stains: A Clinical, Histological and Histochemical Study

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• 作者：E. Grillo^a ; ^{emiliano@doctoremilianogrillo.com" class="auth_mail" title="E-mail the corresponding author} ; P. Gonzá ; lez-Muñ ; oz^b ; P. Boixeda^a ; A. Cuevas^c ; S. Vañ ; ó ; ^a ; P. Jaé ; n^a
• 关键词：Port-wine stain ; Resistant capillary malformations ; Treatment ; Alexandrite laser ; Fluence ; Histochemistry
• 刊名：Actas Dermo-Sifiliográficas (English Edition)
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：107
• 期：7
• 页码：591-596
• 全文大小：1575 K

文摘

Port wine stains (PWSs) are commonly treated by the pulsed dye laser. However, treatment of hypertrophic or resistant PWSs is a major therapeutic challenge. The long-pulsed Alexandrite laser could be a safe and effective treatment for resistant PWSs, due to an increase depth of penetration of 50–75% over PDL.

Objective

The aim of this study was to assess the efficacy and safety of a long-pulsed Alexandrite laser in patients with hypertrophic, dark and/or resistant PWSs. Pink pale resistant PWS were excluded from the study.

Methods

Twenty-one patients (age 20–75 years), phototypes I–IV on the Fitzpatrick scale, with PDL dark resistant PWSs were treated with long-pulsed Alexandrite laser. We excluded high phototypes and PDL pink resistant PWSs. All patients were treated with 3 laser sessions at settings of 3-ms pulse duration, 10-mm spot, 35–55 J/cm², with cooling (Dynamic Cooling Device 50 ms with delay 30 ms). Laser sessions were repeated approximately every 2 months. Three dermatologists evaluated treatment effectiveness by means of photographs of the patients before and after laser treatment (scale from 0 to 4). Adverse events were registered. Patient satisfaction was also assessed (scale from 0 to 10).

Results

Mean global improvement was rated as 2.28. Long-lasting side effects included minimal scarring after blistering in 1 patient. Mean patient satisfaction was 8.5.

Conclusions

Our study concludes that long-pulsed Alexandrite laser was effective for treatment of resistant PWSs, although the therapeutical window is narrow with this treatment.