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The long-pulsed 595-nm PDL using subpurpuric clinical threshold was effective for treatment of rosacea associated telangiectasia.

To determine the risk of cutaneous neoplasia following photochemotherapy (PUVA), we reviewed patients with psoriasis treated at our unit between 1979 and 1991. Two hundred and forty-five patients were assessed, with a median duration of follow-up of 9.5 years. Fifty-nine per cent were male, and 41% female. The median number of exposures was 59, and the median total dose was 133 J/cm2 for the group as a whole. Non-melanoma skin cancers (NMSC) occurred in six individuals (2.4%). Basal cell carcinoma occurred in all six and one individual also developed four squamous cell carcinomas and Bowen's disease of the penis. No cases of malignant melanoma were recorded. Patients who developed NMSC received a median number of 225 exposures and a median cumulative dose of 654 J/cm2. Compared with a control study population in West Glamorgan, Wales, there was a 1.4 (95% confidence limits (CL) 0.5 and 3.1) times increased risk of NMSC. A statistically significant increased incidence of NMSC was found for patients who had received 100 or more exposures, and 250 or more J/cm2, with risks of 3.7 (95% CL 1.0 and 9.5), and 4.0 (95% CL 1.1 and 10), respectively. A PUVA dose of < 250 J/cm2 or < 100 exposures conferred a minimal increase in risk of NMSC in our study population.

BACKGROUND. The pulsed dye laser (PDL), especially the 585nm short-pulse width (450 ls) laser, has been extensively used in the treatment of facial telangiectasias. However, the resultant posttreatment purpura lasts for days and may not be cosmetically acceptable. OBJECTIVE. To examine the effect of long-pulsed (6 ms) PDL at subpurpuric clinical threshold in the treatment of rosaceaassociated telangiectasia. METHODS. Twelve patients with rosacea-associated telangiectasia were recruited into the study. We used the 595-nm PDL at a pulse duration of 6 ms and titrated the fluence between 7 and 9 J/cm 2 to produce immediate purpura lasting only a few seconds. Pretreatment cooling was achieved by cryogen spray. Assessment was made by comparing pretreatment and posttreatment photographs. Patients were evaluated 6 to 8 weeks after one PDL treatment. Results were reported as the percentage of reduction in the number of telangiectasias. Patients were asked for their own evaluation of improvement after treatment in terms of excellent, moderate, or poor outcome. Side effects such as pigmentary disturbance and scarring were also documented. RESULTS. Two of 12 patients had more than 75% improvement. Another two had 50% to 75% improvement, and five had 25% to 50% improvement. Overall, 9 (75%) of 12 patients had more than 25% improvement after a single treatment of PDL. None of the patients reported any lasting posttreatment purpura or complications. CONCLUSION. The long-pulsed 595-nm PDL using subpurpuric clinical threshold was effective for treatment of rosacea associated telangiectasia.