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Nguyen L, Seeber N, Kautz G, Hartjen A, Schneider SW, Herberger K. 532-nm potassium titanyl-phosphate laser versus 595-nm pulsed dye laser for port-wine birthmarks: A prospective, randomized, split-side study. J Eur Acad Dermatol Venereol 2024; 38:1140-1146. [PMID: 38794945 DOI: 10.1111/jdv.19750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/24/2023] [Indexed: 05/26/2024]
Abstract
BACKGROUND Pulsed dye lasers (PDL) are currently the first-line treatment of port-wine birthmarks (PWB). Due to high maintenance costs and instable technology, alternative methods are needed. OBJECTIVES To compare clinical outcomes of a variable-sequenced, long-pulsed 532-nm potassium titanyl-phosphate (KTP) laser and PDL on treating PWB. METHODS A prospective, randomized, split-side study. Patients were treated with a KTP laser and PDL with 1 to 5 sessions at intervals of 6-8 weeks. A follow-up visit was scheduled 6 weeks post-treatment. Efficacy was evaluated through colorimetric analysis, area reduction measurements and clinical evaluations by two blinded investigators based on photo documentation. Subjects provided rating of pain intensity during treatment, post-treatment reactions and satisfaction. Safety was measured by adverse events. Maintenance issues of the laser systems were documented. RESULTS A total of 35 patients (mean age 42.1 years) were enrolled. 63% were female. Patients received 2.4 (SD 1.4; 1-5) treatment sessions. Colorimetric analysis indicated a comparable clearance effect in PWB of both KTP laser and PDL. Independent investigators rated clinical appearance to be significantly improved compared to baseline. No significant difference was observed between both laser systems. Regarding post-treatment reactions, the KTP laser caused less swelling, purpura and crusts. 96% would recommend both treatment modalities. Patients were satisfied with both laser systems. During the study, PDL systems malfunctioned for 6.6 months in total. For the KTP laser, we did not observe any system failures. CONCLUSION Our data indicate that the KTP laser of the latest generation with large-spot sizes, subpulse technology and cryogen cooling has a comparable efficacy to the PDL in treating PWB. In addition, KTP laser is associated with greater tolerability, fewer technical failures and lower repair costs. Further prospective studies are required to determine the true effectiveness of the KTP laser in PWB treatment. This study was preregistered in Clinicaltrials.gov (NCT05771298).
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Affiliation(s)
- Lynhda Nguyen
- Laser Department, Department for Dermatology und Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nikolaus Seeber
- Joint Practice for Dermatology Dres. Peter/Seeber/Altheide, Hamburg, Germany
| | - Gerd Kautz
- Skin and Laser Clinic Dr. Kautz, Konz, Germany
| | - Anna Hartjen
- Laser Department, Department for Dermatology und Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan W Schneider
- Department for Dermatology und Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Herberger
- Laser Department, Department for Dermatology und Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Cubiró X, Garcia-Melendo C, Morales-Munera CE, Riera-Mestre A, Torres-Iglesias R, Villanueva B, Puig L, Baselga E. Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life Evaluation. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:246-257. [PMID: 37913989 DOI: 10.1016/j.ad.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/02/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet. OBJECTIVE To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy. METHODS A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction. RESULTS 111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported. CONCLUSIONS DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
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Affiliation(s)
- X Cubiró
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Dermatology, Hospital de Mollet, Mollet del Vallès, Barcelona, Spain.
| | - C Garcia-Melendo
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Dermatology, Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
| | - C E Morales-Munera
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Riera-Mestre
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - R Torres-Iglesias
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - B Villanueva
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Baselga
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Cubiró X, Garcia-Melendo C, Morales-Munera CE, Riera-Mestre A, Torres-Iglesias R, Villanueva B, Puig L, Baselga E. Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life Evaluation. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T246-T257. [PMID: 38185205 DOI: 10.1016/j.ad.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/16/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet. OBJECTIVE To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy. METHODS A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction. RESULTS 111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported. CONCLUSIONS DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.
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Affiliation(s)
- X Cubiró
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España; Department of Dermatology, Hospital de Mollet, Mollet del Vallès, Barcelona, España.
| | - C Garcia-Melendo
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España; Department of Dermatology, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España
| | - C E Morales-Munera
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - A Riera-Mestre
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España; Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, España
| | - R Torres-Iglesias
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - B Villanueva
- Hereditary Hemorrhagic Telangiectasia Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España
| | - E Baselga
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, España; Institut d'Investigació Biomèdica IIB Sant Pau, Barcelona, España; Universitat Autònoma de Barcelona, Barcelona, España; Department of Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
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Shi MD, Yang K, Li SB, Zhao Q, Huo R, Fu C. Complication rates and safety of pulsed dye laser treatment for port-wine stain: a systematic review and meta-analysis. Lasers Med Sci 2023; 39:16. [PMID: 38141129 DOI: 10.1007/s10103-023-03961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Pulsed dye laser (PDL) is the most commonly used method for port-wine stain (PWS); however, no studies have reported the safety of PDL. This review aimed to collect and summarize complications reported in relevant literature, assess complication rates in treating PWS with PDL, and explore the relevant influencing factors. A systematic review and meta-analysis were conducted to search for related studies in PubMed, Embase, and the Cochrane Library until August 2022. Two reviewers independently evaluated the risk of bias of included studies. Stata Software version 17.0 was used for the analysis. All complications reported in the literature are divided into acute phase complications and long-term complications. Overall pooled purpura, edema, crusting, blistering, hyperpigmentation, hypopigmentation, and scarring rates were 98.3%, 97.6%, 21.5%, 8.7%, 12.8%, 0.9%, and 0.2%, respectively. Although the acute adverse reactions were found to be common, the long-term permanent complications clearly have a lower frequency, and the occurrence of scarring is much lower than that initially thought. This indicates that effective protective measures after treatment are very important for preventing scar formation. Overall, PDL treatment for PWS shows a high level of safety and low chances of causing long-term complications.
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Affiliation(s)
- Meng Dong Shi
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
| | - Kun Yang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
| | - Shu Bo Li
- Department of Burn and Plastic Surgery, The People's Hospital Of Huaiyin Jinan, Jinan, China
| | - Qian Zhao
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran Huo
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Cong Fu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
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Wang Q, Yong C, Wang M, Cui L, Yuan SM. Individualized Surgical Management of Refractory Port-Wine Stains in the Scalp and Face: A Single-Center Retrospective Study and a Discussion of Surgical Strategies. Clin Cosmet Investig Dermatol 2022; 15:1527-1535. [PMID: 35945977 PMCID: PMC9357384 DOI: 10.2147/ccid.s370491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/22/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Qian Wang
- Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Chen Yong
- Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Min Wang
- Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Lei Cui
- Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China
| | - Si-Ming Yuan
- Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China
- Department of Plastic Surgery, Jinling Hospital, Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, 210002, People’s Republic of China
- Correspondence: Si-Ming Yuan, Department of Plastic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China, Email
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Liu L, Zhou L, Zhao Q, Li X, Yang L, Li E, Wei D, Jiang X. Histological analysis of different types of port-wine stains to guide clinical decision making: A retrospective study. Indian J Dermatol Venereol Leprol 2022; 89:204-212. [PMID: 35593279 DOI: 10.25259/ijdvl_730_2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 01/01/2022] [Indexed: 02/05/2023]
Abstract
Background and objectives Port-wine stains are defined as congenital benign vascular lesions. The treatment of port-wine stains remains a challenge, worldwide. This study aimed to analyze the histological characteristics in different types of port-wine stains and provide guidance for clinical decision-making. Methods and materials Biopsies were from the hospital from 2015 to 2021. H&E staining, Immunofluorescence staining, Masson's trichrome staining and Weigert staining were performed on the tissues. Results A total of 35 port-wine stains patients were included in the study of four distinct types, namely red port-wine stains (11 cases), purple port-wine stains (seven cases), hypertrophic port-wine stains (nine cases) and nodular port-wine stains (eight cases). The mean vessel diameter of the different types was 38.7 ± 5.9 μm, 93.5 ± 9.7 μm, 155.6 ± 21.8 μm and 155.6 ± 29.54 μm, respectively. Mean vessel depth was 396.4 ± 31 μm, 944.2 ± 105.4 μm, 2,971 ± 161.3 μm and 3,594 ± 364.6 μm, respectively. The vessels in red port-wine stains, purple port-wine stains and hypertrophic port-wine stains were mainly composed of capillary and venous malformations, whereas those in nodular port-wine stains were venous or arteriovenous malformations. Limitation The main limitation of the current study was the small number of patients. Conclusion As the disease progresses, vessel diameters become larger, the vessel wall becomes thicker and vessels were found in a greater depth. A treatment plan should be scientifically formulated keeping in mind the histological characteristics of port-wine stains.
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Affiliation(s)
- Lian Liu
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
| | - Li Zhou
- Department of Core Facility, West China Hospital, Sichuan University, Wuhou District, Chengdu, Sichuan, China
| | - Qian Zhao
- Department of medical cosmetology, Chengdu Second People's Hospital, Qingyun South Street, Chengdu, Sichuan, China
| | - Xiaoxue Li
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
| | - Lihua Yang
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
| | - Erlong Li
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
| | - Danfeng Wei
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
| | - Xian Jiang
- Department of Dermatology, Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Diseaserelated Molecular Network, Wuhou District, Chengdu, Sichuan, China
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Wang B, Mei X, Wang Y, Hu X, Li F. Adjuncts to pulsed dye laser for treatment of port wine stains: a literature review. J COSMET LASER THER 2022; 23:209-217. [PMID: 35422188 DOI: 10.1080/14764172.2022.2052901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bing Wang
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Xianglin Mei
- Department of Pathology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Yanlong Wang
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
| | - Xin Hu
- Department of Dermatology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, P. R. China
| | - Fuqiu Li
- Department of Dermatology, The Second Hospital of Jilin University, Changchun, P. R. China
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Peng X, Ye T, Yu B, Liu X, Liu L. Comparing HMME-PDT and Cynergy dual-wavelength laser in the treatment of facial PWS. Photodiagnosis Photodyn Ther 2022; 37:102703. [PMID: 34965475 DOI: 10.1016/j.pdpdt.2021.102703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Pulsed dye laser (PDL) is the gold-standard therapy for port-wine stains (PWSs), but the therapeutic efficacies vary widely with each individual. Recent studies suggest that hematoporphyrin monomethyl ether-photodynamic therapy (HMME-PDT) is an effective alternative in the treatment of PWS. This retrospective study aimed to compare the effects of HMME-PDT and Cynergy dual-wavelength laser on red and purple color types of PWS METHODS: This retrospective study included 38 PWS patients who received Cynergy dual-wavelength laser treatment (PDL group) and 39 PWS patients who received HMME-PDT treatment (HMME-PDT group). Patients in each group received two treatments. The curative effect of purple or red PWS in two groups was analyzed. RESULTS After the first treatment, the total significant response rate and the total response rate of the HMME-PDT group were 43.59% and 74.36%, which were significantly higher than those of the PDL group (5.26% and 47.36%) (P < 0.05). After the second treatment, the total significant response rate and the total response rate of the HMME-PDT group were 69.23% and 100%, which were obviously higher than those of the PDL group (34.21% and 68.42%) (P < 0.05). For both groups, the total significant response rate of purple-type PWS was remarkably higher than that of red-type PWS (the HMME-PDT group: P = 0.004; the PDL group: P = 0.048). There was no obvious difference in terms of patient age and PWS location between the HMME-PDT and PDL groups. Furthermore, there was no considerable difference in the incidence of adverse reactions between the two groups (P > 0.05). CONCLUSION The single-center retrospective study suggested that HMME-PDT might have better efficacies on purple and red PWS than PDL treatment. The total treatment efficacy was greater in purple-type PWS than in red-type PWS.
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Affiliation(s)
- Xi Peng
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, 518036, Shenzhen, China
| | - Tinglu Ye
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, 518036, Shenzhen, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, 518036, Shenzhen, China
| | - Xiaoming Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, 518036, Shenzhen, China
| | - Lanting Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, 518036, Shenzhen, China; Department of Dermatology,Shenzhen Nanshan Hospital, Shenzhen, 518000, China
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Sequential Use of CO 2 Laser Prior to Nd:YAG and Dye Laser in the Management of Non-Facial Warts: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010115. [PMID: 35056422 PMCID: PMC8780825 DOI: 10.3390/medicina58010115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/26/2022]
Abstract
Background and Objectives: Warts are benign lesions of viral etiology characterized by a hyperkeratotic appearance tending to spread across the skin surface. Various treatments have been proposed to manage this condition, such as acids, imiquimod, photodynamic therapy, cryotherapy, and various lasers. Materials and Methods: In this paper, we describe a combination protocol using CO2 laser prior to Nd:YAG laser for lesions interesting the palmoplantar areas or dye laser for lesions on other skin surfaces in the management of non-facial warts resistant to traditional therapies. In total, 34 patients with 103 warts suffering from wart infection resistant to traditional therapies treated from 1 January 2019 to 1 June 2020 were retrospectively enrolled at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). Two dermatologists measured clinical results, classifying lesions with complete resolution, partial resolution, or non-responding. Patients at four months follow-up were asked to evaluate their degree of satisfaction with a visual analog scale (VAS). Results: Almost all patients reported the complete resolution of lesions, with no patient reporting scarring. Five patients reported hypopigmentation in the treated areas. The mean satisfaction level was high. Only three patients experienced a relapse of the condition. Conclusions: Using a vascular laser following a CO2 superficial ablation of warts may help reduce the risk of scarring and decrease the incidence of relapses for lesions resistant to traditional therapies. Therefore, more extensive studies will be necessary to confirm the obtained results.
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Therapeutic Strategies for Untreated Capillary Malformations of the Head and Neck Region: A Systematic Review and Meta-Analyses. Am J Clin Dermatol 2021; 22:603-614. [PMID: 34160795 PMCID: PMC8421304 DOI: 10.1007/s40257-021-00616-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 01/19/2023]
Abstract
Background Capillary malformations of the head and neck region often cause psychological and physical burden. As the effectiveness of modern laser and light therapies is still suboptimal, patients often seek different therapeutic strategies. Other recognized, but not routinely proposed therapies include cosmetic camouflage, surgery, and medical tattooing. Information on therapeutic outcomes is currently lacking for patients to adequately participate in the treatment decision-making process. Objective The objective of this systematic review was to review the effectiveness and safety of recognized therapies for untreated capillary malformations of the head and neck: laser and light treatment modalities, photodynamic therapy, cosmetic camouflage, medical tattooing, and surgery. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to 16 December, 2020 for observational and experimental studies examining recognized therapies for untreated capillary malformations of the head and neck. Two reviewers independently evaluated the risk of bias of included studies. Predefined treatment and safety outcomes of pooled data were scored using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results We included 48 observational and three randomized studies (totaling 3068 patients), evaluating nine different therapies. No studies on surgery or cosmetic camouflage matched our inclusion criteria. The pooled proportion of patients reaching a ≥75% clearance was 43% (95% confidence interval 24–64%; I2 = 55%) for the pulsed dye laser after three to eight treatment sessions (GRADE score: very low). Other therapies were less effective. Hyperpigmentation was most frequently described after the pulsed dye laser (incidences up to 40%). Pain was most common after photodynamic therapy, yet the intensity was unreported. Substantial heterogeneity among studies as to patient characteristics and outcomes limited pooling and data comparisons. Conclusions The pulsed dye laser seems preferable for treatment-naive capillary malformations of the head and neck region, yet demonstrates greater hyperpigmentation rates compared with other therapies. Our results are, however, based on low-quality evidence. Future studies using uniform outcome measures and validated metrics are warranted for study comparability. Based on this systematic review, clinicians and patients should be aware of the limited evidence about the available options when making (shared) treatment decisions for capillary malformations. Trial Registration Review registration number PROSPERO database: CRD42020199445. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-021-00616-5.
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Shi H, He J, Guo H, Liu X, Wang Z, Liu YG. Single-resonator, stable dual-longitudinal-mode optofluidic microcavity laser based on a hollow-core microstructured optical fiber. OPTICS EXPRESS 2021; 29:10077-10088. [PMID: 33820142 DOI: 10.1364/oe.418936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
A single-resonator, stable dual-longitudinal-mode optofluidic microcavity laser based on a hollow-core microstructured optical fiber is proposed and experimentally demonstrated. The resonator and microfluidic channel are integrated in the hollow-core region of the fiber, inside which a hexagonal silica ring is used as the only resonator of the laser. Experimental results show that with mixing a small amount of Rhodamine B into a 1 mM Rhodamine 6G solution to form a dual-dye solution as a gain medium, the laser obtained by the method of lateral pumping can operate at dual longitudinal modes, with a threshold of 90 nJ/mm2. By adjusting the concentration of Rhodamine B, the lasing wavelength of the laser and the power ratio of the two wavelengths can be controlled. And because the laser emission is co-excited by different kinds of dye molecules, the mode competition is diminished, enabling the simultaneously efficient optical gain and therefore lasing at dual longitudinal modes stably with a maximum lasing intensity fluctuation of 3.2% within 30 minutes even if the dual longitudinal modes have the same linear polarization states. This work can open up promising opportunities for diverse applications in biosensing and medical diagnosis with high sensitivity and integrated photonics with compact structure.
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Wanitphakdeedecha R, Jantarakolica T, Ng JNC, Yan C, Nanchaipruek Y, Jantanapornchai N, Manuskiatti W, Sudhipongpracha T. The Cost-Effectiveness of Pulsed-Dye Laser Therapy Among Thai Patients with Facial Port-Wine Stain: A Retrospective Study and Economic Evaluation. Dermatol Ther (Heidelb) 2021; 11:465-473. [PMID: 33481216 PMCID: PMC8019004 DOI: 10.1007/s13555-021-00484-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Port-wine stain (PWS) is a progressive capillary malformation that does not resolve spontaneously without treatment. Pulsed dye laser (PDL) is currently the gold standard treatment for PWS, although it is difficult to attain complete clearance and recurrences are common. This study determined the cost-effectiveness of PDL treatment among Thai patients with facial PWS. Methods This was a retrospective chart review of 109 Thai patients with facial PWS and treated with PDL at Siriraj Hospital, Thailand from January 2008 to December 2017. The primary outcome of the study was the cost-effectiveness of PDL treatment in the clinical improvement of facial PWS. Results Ten PDL treatment sessions will have an expected clinical improvement of 60%. At the 10th treatment, the marginal incremental improvement with respect to visit is approximately equal to one. The succeeding treatment sessions will only give an additional improvement of 5–10%. Conclusion A total of 10 PDL treatment sessions was considered cost-effective as it can achieve 60% clinical improvement among Thai patients with facial PWS.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. .,College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand.
| | | | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yanisorn Nanchaipruek
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nuttagarn Jantanapornchai
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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van Raath MI, Chohan S, Wolkerstorfer A, van der Horst CMAM, Limpens J, Huang X, Ding B, Storm G, van der Hulst RRWJ, Heger M. Clinical outcome measures and scoring systems used in prospective studies of port wine stains: A systematic review. PLoS One 2020; 15:e0235657. [PMID: 32614899 PMCID: PMC7332045 DOI: 10.1371/journal.pone.0235657] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/21/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Valid and reliable outcome measures are needed to determine and compare treatment results of port wine stain (PWS) studies. Besides, uniformity in outcome measures is crucial to enable inter-study comparisons and meta-analyses. This study aimed to assess the heterogeneity in reported PWS outcome measures by mapping the (clinical) outcome measures currently used in prospective PWS studies. METHODS OVID MEDLINE, OVID Embase, and CENTRAL were searched for prospective PWS studies published from 2005 to May 2020. Interventional studies with a clinical efficacy assessment were included. Two reviewers independently evaluated methodological quality using a modified Downs and Black checklist. RESULTS In total, 85 studies comprising 3,310 patients were included in which 94 clinician/observer-reported clinical efficacy assessments had been performed using 46 different scoring systems. Eighty-one- studies employed a global assessment of PWS appearance/improvement, of which -82% was expressed as percentage improvement and categorized in 26 different scoring systems. A wide variety of other global and multi-item scoring systems was identified. As a result of outcome heterogeneity and insufficient data reporting, only 44% of studies could be directly compared. A minority of studies included patient-reported or objective outcomes. Thirteen studies of good quality were found. CONCLUSION Clinical PWS outcomes are highly heterogeneous, which hampers study comparisons and meta-analyses. Consensus-based development of a core outcome-set would benefit future research and clinical practice, especially considering the lack of high-quality trials.
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Affiliation(s)
- M. Ingmar van Raath
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang, PR China
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sandeep Chohan
- Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Chantal M. A. M. van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Medical Library, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Xuan Huang
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Baoyue Ding
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Gert Storm
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - René R. W. J. van der Hulst
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Michal Heger
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, Zhejiang, PR China
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Mao J, Wang H, Xie Y, Fu Y, Li Y, Liu P, Du H, Zhu J, Dong L, Hussain M, Li Y, Zhang L, Zhu J, Tao J. Transdermal delivery of rapamycin with poor water-solubility by dissolving polymeric microneedles for anti-angiogenesis. J Mater Chem B 2020; 8:928-934. [PMID: 31912081 DOI: 10.1039/c9tb00912d] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Angiogenesis plays an important role in the occurrence and development of skin tumors and vascular anomalies (VAs). Many drugs have been adopted for the inhibition of angiogenesis, among which rapamycin (RAPA) possesses good application prospects. However, the clinical potential of RAPA for VAs is limited by its poor solubility, low bioavailability, and high cytotoxicity. To extend its application prospect for VAs treatment, in this study, we develop RAPA-loaded dissolving polymeric microneedles (RAPA DMNs) made of polyvinylpyrrolidone (PVP) due to its excellent solubilizing ability. RAPA DMNs are shown to have sufficient mechanical strength to overcome the skin barrier of the stratum corneum and could deliver RAPA to a depth of 200 μm. The microneedle shafts completely dissolve and 80% of the drug could be released within 10 min after insertion ex vivo. The DMNs-penetrated mice skin could repair itself within 4 h after the application of RAPA DMNs. RAPA DMNs also show good anti-angiogenic effect by inhibiting the growth of human umbilical vein endothelial cells (HUVECs) and decreasing the secretion of vascular endothelial growth factor (VEGF). Therefore, RAPA DMNs promisingly provide a safe and efficient approach for VAs treatment.
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Affiliation(s)
- Jinzhu Mao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Hua Wang
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Ying Xie
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Yangxue Fu
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Yuce Li
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Pei Liu
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Hongyao Du
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Jinjin Zhu
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Liyun Dong
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Mubashir Hussain
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Yan Li
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
| | - Lianbin Zhang
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Jintao Zhu
- Key Laboratory of Material Chemistry for Energy Conversion and Storage (HUST) of Ministry of Education, School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology (HUST), Wuhan 430074, China.
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan 430022, China.
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Sarac G, Kapicioglu Y. Efficacy of 577‐nm Pro‐Yellow laser in port wine stain treatment. Dermatol Ther 2019; 32:e13078. [DOI: 10.1111/dth.13078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/13/2019] [Accepted: 08/26/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Gulbahar Sarac
- Turgut Ozal Medical Center, Department of DermatologyInonu University Faculty of Medicine Malatya Turkey
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Hu M, Ke Y, Li Q, Zhou X, Lu Y, Yang G, Bi M. Tunable dual-wavelength laser based on Nd:YVO 4/Nd:GdVO 4 combined crystal. OPTICS EXPRESS 2019; 27:13773-13780. [PMID: 31163836 DOI: 10.1364/oe.27.013773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
A tunable dual-wavelength laser (DWL) based on Nd:YVO4/Nd:GdVO4 combined crystal is presented. The frequency separation tuning characteristics of the DWL are investigated experimentally. In the experiments, the DWL with tunable frequency separation is obtained with fixed pumping power and controlled heat sink temperature (Tc) of the combined crystal. The frequency separations are measured at 351.11-316.15 GHz by varying Tc from 5.0 °C to 40.0 °C, with a slope of -0.95 GHz/°C. When Tc is kept at 32.3 °C, a 435-mW power-balanced DWL signal is achieved with frequency separation at 324.29 GHz. By analyzing the experimental results from the perspective of thermal-induced emission cross section (ECS) spectra evolution of the combined crystal, it is found the frequency separation tuning of the DWL is caused by the different ECS spectral wavelength shifting rates of the Nd:YVO4 and Nd:GdVO4 crystals with Tc varying. The analysis results are in good agreement with the experimental results.
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Cho SB, Ahn KJ, Oh D, Kim H, Yoo KH. Sequential delivery of long-pulsed 755-nm alexandrite laser and long-pulsed 1,064-nm neodymium:yttrium-aluminum-garnet laser treatment for pigmented disorders. Skin Res Technol 2019; 25:683-692. [PMID: 31056804 DOI: 10.1111/srt.12704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 02/17/2019] [Accepted: 04/14/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Long-pulsed (LP) lasers at pulse durations of 1-300 ms have been used to destroy nests of nevi cells by selectively targeting pigment chromophores. OBJECTIVE To evaluate dual-wavelength LP laser-induced tissue reactions. METHODS The patterns of LP 755-nm alexandrite (Alex) and/or 1064-nm neodymium (Nd):yttrium-aluminum-garnet (YAG) laser-induced tissue reactions were macroscopically evaluated using a tattoo-embedded phantom. Additionally, a pilot in vivo human study was performed for common acquired melanocytic nevus, of which dermoscopic images and high-speed cinematographs were obtained. RESULTS Combinations of Nd:YAG and Alex laser treatments at interpulse intervals of 10 or 20 ms generated round to oval zones of photothermal and photoacoustic injury in two distinctive areas containing disintegrated tattoo particles. Treatment at interpulse intervals of 10 or 20 ms between Alex and Nd:YAG pulses elicited lesser degrees of thermal damage to surrounding tissues, compared to treatment at 100 or 200 ms. Immediately after combined LP laser treatment of human nevus lesions in vivo, Nd:YAG-Alex treatment at a 20-ms interpulse interval exhibited more remarkable crusting and erosive appearances than Alex-Nd:YAG treatment. CONCLUSION For treating pigmented disorders, sequential delivery of LP Nd:YAG and Alex pulses at short interpulse intervals of 10-20 ms can effectively destroy nests of pigment chromophores.
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Affiliation(s)
- Sung Bin Cho
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.,Yonsei Seran Dermatology and Laser Clinic, Seoul, Korea
| | - Keun Jae Ahn
- Department of Science Education, Jeju National University, Jeju, Korea
| | - Doojin Oh
- Cheongdam Suan Dermatology Clinic, Seoul, Korea
| | - Heesu Kim
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Kwang Ho Yoo
- Department of Dermatology and Cutaneous Biology Research Center, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
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Periyasamy MK, Sekar CS, Rai R. Effectiveness of Dual Sequential Wavelength Laser in the Treatment of Portwine Stains - A Retrospective Study. Indian Dermatol Online J 2019; 10:418-421. [PMID: 31334061 PMCID: PMC6615402 DOI: 10.4103/idoj.idoj_483_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. The 1064-nm long pulsed Nd:YAG laser has greater depth of penetration and is used to treat deeper vessels. The dual sequential wavelength laser (DSWL) which combines PDL/Nd:YAG (595/1064 nm) can be more effective for the treatment of deeper, nodular portwine stains due to its synergistic effect. The purpose of this study is to evaluate the efficacy and safety of DSWL in the treatment of portwine stains after five treatment sessions. Materials and Methods A total of 11 patients with PWS lesions on the head and neck, who were treated with DSWL for at least five sittings at monthly interval were included in this study. The assessment of the therapeutic response and grading of improvement was done with a scale of 0 to 4 by comparing the photographs taken before treatment and after 5 sittings of laser treatment. Results Out of the 11 patients, 5 patients (45.45%) had more than 70% improvement. Six out of eleven patients (54.54%) had 40 to 70% improvement at the end of five sittings with no adverse effects including purpura. Conclusion Dual Sequential Wavelength Laser is a good modality of treatment for portwine stains. It has enhanced penetration and effective clearance of thicker, nodular, recalcitrant lesions of PWS. DSWL is safe and efficacious and it can be recommended as a therapeutic modality for portwine stains.
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Affiliation(s)
| | - C Shanmuga Sekar
- Department of Dermatology, PSG Hospitals, Coimbatore, Tamil Nadu, India
| | - Reena Rai
- Department of Dermatology, PSG Hospitals, Coimbatore, Tamil Nadu, India
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Topical Adjuncts to Pulsed Dye Laser for Treatment of Port Wine Stains: Review of the Literature. Dermatol Surg 2018; 44:796-802. [PMID: 29799824 DOI: 10.1097/dss.0000000000001507] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Port wine stains (PWS) pose a therapeutic challenge. Pulsed dye laser (PDL) is the treatment of choice; however, treatment is often ineffective and recurrences are common. OBJECTIVE This article provides a review of topical therapies that have been investigated to improve efficacy of PDL for the treatment of PWS. MATERIALS AND METHODS A literature search was performed through PubMed, EMBASE, Web of Science, and CINAHL, using the search terms "port wine stain," "pulsed dye laser," and "topical." RESULTS Clinical trials have investigated the topical agents, timolol, imiquimod, and rapamycin (RPM) in combination with PDL for the treatment of PWS. Topical timolol with PDL failed to show improved efficacy compared with PDL alone. Two clinical trials using imiquimod and PDL showed enhanced blanching of PWS compared with controls. Rapamycin and PDL were more effective than controls for facial PWS, but not for nonfacial PWS. CONCLUSION Topical imiquimod and RPM have shown some efficacy in treating PWS with PDL, but to date there is no topical adjuvant to PDL that reliably improves results for PWS.
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