Adverse reactions following pulsed tunable dye laser treatmentof port wine stains in 701 patients

Seukeran, D.C.; Collins, Paul M.; Sheehan-Dare, R. A.

doi:10.1046/j.1365-2133.1997.6631648.x

Cited by 52 publications

(60 citation statements)

References 9 publications

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“…They also contrast with the responses seen using PDL in treating PWS in infants. Although atrophic scarring can occur as a sequelae of PDL for PWS, to our knowledge, severe ulceration rarely, if ever, does so [1][2][3][4]26,27].…”

Section: Discussionmentioning

confidence: 76%

Complications following pulsed dye laser treatment of superficial hemangiomas

et al. 2006

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Background and ObjectivePulsed dye laser (PDL) has been reported to be safe and effective in the management of superficial hemangiomas of infancy. We report 12 patients with hemangiomas with complications following PDL.Study Design/Materials and MethodsRecords of patients with hemangiomas and a known adverse outcome following PDL were reviewed.ResultsAll were treated early (age range: 5 days to 4 months), and all hemangiomas were facial with a superficial component. Eleven were treated with a 585 nm wavelength, fluence range of 4.7–7 J/cm2, without dynamic cooling. One patient received 7–12 J/cm2 utilizing a 595 nm wavelength with dynamic cooling. In eight cases, treatment led to severe ulceration with subsequent pain, scarring, and in one instance, life‐threatening hemorrhage. In four, permanent atrophic scarring was noted without ulceration.ConclusionsPDL treatment of superficial hemangiomas may rarely lead to significant complications including atrophic scarring and severe ulceration. Lasers Surg. Med. 38:116–123, 2006. © 2006 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 76%

Complications following pulsed dye laser treatment of superficial hemangiomas

et al. 2006

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“…This approximately corresponds to the references with regard to the application of IPLS for leg telangiectases (blisters, 2%-42%; hypopigmentation, 3%-20%; hyperpigmentation, 4%-50%; scarring, 0.5%-21%). 24,25 In the treatment of PWSs, FLPDL caused comparatively frequent postinflammatory hyperpigmentation reported at a frequency of 9% to 57 % 5,6,32,35,[46][47][48] and postinflammatory hypopigmentation in 2% to 10 %. 3,4,6,16,46 Hyperpigmentation and hypopigmentation were also the most common transient side effects of the long-pulsed FLPDL treatment of leg veins.…”

Section: Commentmentioning

confidence: 99%

Treatment of Port-wine Stains With a Noncoherent Pulsed Light Source

Raulin¹,

Schroeter²,

Weiß³

et al. 1999

Arch Dermatol

129

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Objective: The flashlamp pulsed dye laser (FLPDL) is currently the treatment of choice for port-wine stains (PWS). We recently investigated whether a non-coherent intense pulsed light source (IPLS) would be effective in the therapy of PWS. Design and Patients:In order to evaluate the efficacy in treatment of PWS (especially adult-type dark and hypertrophic), a retrospective study of 37 patients (randomly selected) with a total of 40 PWS treated with IPLS was initiated. Clinical PWS characteristics recorded were color and location of the PWS. Data collected included treatment parameters (filters, pulse duration, fluence and pulse sequencing), % clearance, and side effects (purpura, blisters, crusting, altered pigmentation and scarring).Results: Good and complete (70-100 %) clearance was achieved in 28 of 40 PWS treated with IPLS. Average number of treatment sessions in PWS reaching 100 % clearance included 4.0 for pink PWS and 1.5 sessions for red PWS. Average number of sessions in purple PWS reaching good clearance (70-99%) was 4.2 sessions. Parameters used most frequently were 515 and 550 nm cut-off-filters, pulse duration of 2.5-5.0 ms and fluences of 24 to 60 J/cm 2 . Side effects included purpura in 76%, superficial blisters in 8% and crusting in 20%. Transient pigmentation changes were seen in 10.8% of patients (hypopigmentations in 8.1%, hyperpigmentation in 2.7%). No scarring was observed. Conclusion:IPLS presents an effective and safe method for treating PWS, especially dark and facial PWS.

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“…13 The association between scarring and depth of dermal injury is clinically recognized and is evident from lasers used to treat superficial vascular malformations and for facial resurfacing. 14,15 The depth of the injury, as well as the site of the wound, dictate the outcome of wound appearance, where superficial burn will heal quickly without scar. In a porcine skin wound model, deep partial thickness dermal burn resulted in HTS.…”

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confidence: 99%

Deep dermal fibroblasts contribute to hypertrophic scarring

Wang

Dodd

Shankowsky

et al. 2008

Laboratory Investigation

184

140

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Hypertrophic scar (HTS) following thermal injury is a dermal fibroproliferative disorder that leads to considerable morbidity. The development of HTS involves numerous cell types and cytokines with dermal fibroblasts being a key cell. We have previously reported that the phenotype of fibroblasts isolated from HTS was altered compared to fibroblasts from normal skin. In this study, normal skin was horizontally sectioned into five layers using a dermatome from which fibroblasts were isolated and cultured. Cells from the deeper layers were observed to proliferate at a slow rate, but were morphologically larger. In ELISA and FACS assays, cells from the deeper layers produced more TGF-b1 and TGF-b1 producing cells were higher. In quantitative RT-PCR, the cells from the deeper layers had higher CTGF and HSP47 mRNA levels compared to those from superficial layers. In western blot, FACS and collagen gel assays, fibroblasts from the deeper layers produced more a-smooth muscle actin (a-SMA), had higher a-SMA positive cells and contracted collagen gels more. Fibroblasts from the deeper layers were also found to produce more collagen, but less collagenase by mass spectrometry and collagenase assay. Interestingly, cells from the deeper layers also produced more of the proteoglycan, versican, but less decorin. Taken together, these data strongly demonstrate that fibroblasts from the deeper layers of the dermis resemble HTS fibroblasts, suggesting that the deeper layer fibroblasts may be critical in the formation of HTS. Hypertrophic scarring is a common fibroproliferative disorder of the human dermis characterized by erythematous, raised, pruritic lesions of the healing skin, which is usually following thermal and other injuries that involve the deep dermis. 1 These lesions lead to scarring that compromises the appearance of healing skin and are commonly associated with contractures that limit movement and function of involved joints and facial features. As such, HTS is the principal factor that contributes to the prolonged and often uncomfortable rehabilitation period for thermally injured patients, particularly those who have survived large lifethreatening injuries, children, and individuals of dark-skinned races, in whom such scarring occurs more commonly. 2 The undesirable physical properties of HTS tissue can be attributed to the presence of a large amount of extracellular matrix that is of altered composition and organization, compared to normal dermis or mature scar. This matrix is the product of a dense population of fibroblasts, maintained in a hyperactive state by inflammatory cytokines such as TGF-b and other factors, some of which may be physical in origin. 3 Although the molecular and cellular events that lead to HTS have been extensively studied, the pathogenesis of this condition is still not well understood, making treatment difficult.Key cells involved in HTS are the dermal fibroblasts. Dermal fibroblasts are a dynamic and diverse population of cells whose function in skin and HTS in many respects remain unkn...

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Adverse reactions following pulsed tunable dye laser treatmentof port wine stains in 701 patients

Cited by 52 publications

References 9 publications

Complications following pulsed dye laser treatment of superficial hemangiomas

Complications following pulsed dye laser treatment of superficial hemangiomas

Treatment of Port-wine Stains With a Noncoherent Pulsed Light Source

Deep dermal fibroblasts contribute to hypertrophic scarring

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