Ann Dermatol.  2012 Aug;24(3):306-310. 10.5021/ad.2012.24.3.306.

Clinical Experience in the Treatment of Port-Wine Stains with Blebs

• Lee HR
• Han TY
• Kim YG
• Lee JH

• KMID: 2265303
• DOI: http://doi.org/10.5021/ad.2012.24.3.306

Abstract

BACKGROUND
The current modality of choice for the treatment of Port-wine stains (PWS) is laser photocoagulation. Laser therapy for the treatment of PWS, especially with a pulsed dye laser (PDL), has been proven safe and effective; however, because penetration of the PDL is too shallow for an effective ablation of the blebs, treatment of blebbed PWS, using PDL, may be insufficient.
OBJECTIVE
We demonstrated the clinical efficacy of a 1,064 nm long pulsed Nd:YAG laser with contact cooling device for blebbed PWS.
METHODS
Twenty one patients with blebbed PWS (Fitzpatrick skin types II-V) underwent a treatment, using a 1,064 nm long pulsed Nd:YAG laser with a contact cooling device at 8-week intervals. Treatments were done using 5~6 mm spot sizes at 20~30 ms and 95~170 J/cm2. Laser parameters were adjusted in order to meet the needs of each individual patient's lesions.
RESULTS
All subjects tolerated the treatments well, and showed clinical improvement from blebs. Of the 21 patients, 18 of them experienced either moderate or excellent response.
CONCLUSION
Use of a 1,064 nm long pulsed Nd:YAG laser results in a greater depth of vascular coagulation. A 1,064 nm long pulsed Nd:YAG laser with contact cooling device may be regarded as a promising therapeutic option for the treatment of blebbed PWS.

Keyword

Blebs; Contact cooling device; Nd:YAG lasers; Port-wine stains; Pulsed dye laser

MeSH Terms

Blister
Humans
Laser Therapy
Lasers, Dye
Light Coagulation
Port-Wine Stain
Skin

Figure

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  Fig. 1 Patient 7. (A) Several violaceous nodules with surrounding erythematous flat plaques on the left cheek (V2 distribution of a trigeminal location), (B) On blebs, three sessions of treatment with a 1,064 nm long pulsed Nd:YAG laser with contact cooling and six sessions of PDL on surrounding flat lesions.

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  Fig. 2 Patient 11. (A) Asymptomatic multiple purple nodules with surrounding erythematous flat plaques on the right cheek and nose (V2 distribution of a trigeminal location), (B) On blebs, one session of treatment with a 1,064 nm long pulsed Nd:YAG laser with contact cooling and five sessions of pulsed dye laser on surrounding flat lesions.

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