Variables affecting clinical response to treatment of facial port-wine stains by flash lamp-pumped pulsed dye laser: the importance of looking beyond the skin

详细信息    查看全文

• 作者：Pier Luca Bencini (1)
  Simone Cazzaniga (2)
  Michela Gianna Galimberti (1)
  Cristina Zane (3)
  Luigi Naldi (2) (4) (5)
  
• 关键词：Port ; wine stains (PWS) ; Flash lamp ; pumped pulsed (FLPP) dye laser ; Treatment ; Capillaroscopic pattern ; Hemodynamic variables ; Cohort study
• 刊名：Lasers in Medical Science
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：29
• 期：4
• 页码：1365-1370
• 全文大小：414 KB
• 参考文献：1. Shirley MD, Tang H, Gallione CJ et al (2013) Sturge–Weber syndrome and port-wine stains caused by somatic mutation in GNAQ. N Engl J Med 368:1971-979 CrossRef
  2. Jacobs AH, Walton RG (1976) The incidence of birthmarks in the neonate. Pediatrics 58:218-22
  3. Alster TS, Lewis AB (1996) Dermatologic laser surgery. A review. Dermatol Surg 22:797-05
  4. Bucci J, Goldberg D (2006) Past, present and future: vascular laser/light devices. J Cosmet Laser Ther 28:149-53 CrossRef
  5. Kauvar A (1997) Long pulse and high energy pulsed dye laser treatment of port wine stains and hemangioma. Presented at the 24th Annual Meeting of the American Society of Dermatological Surgery, Boston
  6. Sivarajan V, Maclaren WM, Mackay IR (2006) The effect of varying pulse duration, wavelength, spot size and fluence on the response of previously treated capillary vascular malformations to pulsed-dye laser treatment. Ann Plast Surg 57:25-2 CrossRef
  7. Jasim ZF, Handley JM (2007) Treatment of pulsed dye laser-resistant port-wine stain birthmarks. J Am Acad Dermatol 57:677-82 CrossRef
  8. Bencini PL (1999) The multilayer technique: a new and fast approach for flash-pumped pulsed (FLPP) dye laser treatment of port wine stains (preliminary reports). Dermatol Surg 25:786-89 CrossRef
  9. Rajaratnam R, Laughlin SA, Dudley D (2011) Pulsed dye laser double-pass treatment of patients with resistant capillary malformations. Lasers Med Sci 26:487-92 CrossRef
  10. Adatto MA, Luc-Levy J, Mordon S (2010) Efficacy of a novel intense pulsed light system for the treatment of port wine stains. J Cosmet Laser Ther 12:54-0 CrossRef
  11. Izikson L, Nelson JS, Anderson RR (2009) Treatment of hypertrophic and resistant port wine stains with a 755?nm laser: a case series of 20 patients. Lasers Surg Med 41:427-32 CrossRef
  12. Yang MU, Yaroslavsky AN, Farinelli WA et al (2005) Long-pulsed neodymium:yttrium–aluminium–garnet laser treatment for port-wine stains. J Am Acad Dermatol 52:480-90 CrossRef
  13. Kono T, Frederick Groff W, Chan HH, Sakurai H, Yamaki T (2009) Long-pulsed neodymium:yttrium–aluminum–garnet laser treatment for hypertrophic port-wine stains on the lips. J Cosmet Laser Ther 11:11-3 CrossRef
  14. Geronemus RG (2006) Long-pulsed neodymium:yttrium–aluminum–garnet laser treatment for port wine stains. J Am Acad Dermatol 54:923 CrossRef
  15. Landthaler M, Hohenleutner U, Abd El Raheem TA (1995) Therapy of vascular lesions in the head and neck area by means of argon, Nd:YAG, and flashlamp-pumped pulsed dye lasers. Adv Otorhinolaryngol 49:81-6
  16. Borges da Costa J, Boixeda P, Moreno C, Santiago J (2009) Treatment of resistant port-wine stains with a pulsed dual wavelength 595 and 1064?nm laser: a histochemical evaluation of the vessel wall destruction and selectivity. Photomed Laser Surg 27:599-05 CrossRef
  17. Whang KK, Byun JY, Kim SH (2009) A dual-wavelength approach with 585-nm pulsed-dye laser and 800-nm diode laser for treatment-resistant port-wine stains. Clin Exp Dermatol 34:436-37 CrossRef
  18. Alster TS, Tanzi EL (2009) Combined 595-nm and 1,064-nm laser irradiation of recalcitrant and hypertrophic port-wine stains in children and adults. Dermatol Surg 35:914-18 CrossRef
  19. Eubanks LE, McBurney EI (2001) Videomicroscopy of port-wine stains: correlation of location and depth of lesion. J Am Acad Dermatol 44:948-51 CrossRef
  20. No authors listed (2007) Summary of the 2007 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension. Vasc Health Risk Manag 3:783-5
  21. Renfro L, Geronemus RG (1993) Anatomical differences of port-wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 129:182-88 CrossRef
  22. Motley RJ, Lanigan SW, Katugampola GA (1997) Videomicroscopy predicts outcome in treatment of port-wine stains. Arch Dermatol 133:921-22 CrossRef
  23. Taddei S, Salvetti A (2002) Endothelial dysfunction in essential hypertension: clinical implications. J Hypertens 20:1671-674 CrossRef
  24. Hoefer IE, den Adel B, Daemen MJ (2013) Biomechanical factors as triggers of vascular growth. Cardiovasc Res. doi:10.1093/cvr/cvt089
  25. Cheung CY, Tay WT, Mitchell P et al (2011) Quantitative and qualitative retinal microvascular characteristics and blood pressure. J Hypertens 29:1380-391 CrossRef
  26. Schreiber S, Bueche CZ, Garz C, Braun H (2013) Blood brain barrier breakdown as the starting point of cerebral small vessel disease?—New insights from a rat model. Exp Transl Stroke Med 5:4 CrossRef
  
• 作者单位：Pier Luca Bencini (1)
  Simone Cazzaniga (2)
  Michela Gianna Galimberti (1)
  Cristina Zane (3)
  Luigi Naldi (2) (4) (5)
  
  1. Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Milano, Italy
  2. Centro Studi GISED, Fondazione per la Ricerca Ospedale Maggiore, Bergamo, Italy
  3. Clinica Dermatologica, Spedali Civili, Brescia, Italy
  4. Italian High Tech Network in Dermatological Sciences, Milano, Italy
  5. Unità di Dermatologia, Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy
  
• ISSN：1435-604X

文摘

The response of port-wine stains (PWS) to conventional laser treatment in adults is difficult to predict. To assess the influence of local or systemic hemodynamic variables on the clearance of PWS by using flash lamp-pumped pulsed (FLPP) dye laser. All consecutive patients ages 18?years or older undergoing laser treatment for a facial PWS were eligible. Laser sessions were scheduled every 8?weeks. All patients were evaluated based on a standard scale with four evaluation categories, from no or minimal improvement to total or almost total clearance. Clearance was achieved by 50.1?% (95?% confidence interval 35.6-4.7) of patients after a maximum of 15 treatment sessions. In multivariate analysis, increased age, a newly described Type III capillaroscopic pattern, and presence of lesions in dermatome V2 were all associated with a reduced clinical response to treatment. In a model restricted to demographic pattern and patient characteristics, arterial hypertension was also associated with a lower clinical response. A strong association was found between arterial hypertension and the Type III capillaroscopic pattern. Age, arterial hypertension, capillaroscopic pattern, and body location should be considered when planning laser treatment of PWS.