Comparing the therapeutic effect of pulsed dye laser and pulsed dye laser plus CO2 in port wine stain

Abstract

Introduction: One of the most common congenital vascular abnormalities in the dermal area of the skin is the port-wine stain (PWS). Aim: Researchers are trying to introduce more effective new methods of treatment of PWS. Material and methods: This clinical trial study was conducted on 60 patients in Huanggang Central Hospital during May 2020 to June 2021. Pulsed dye laser (PDL) only and PDL plus CO2 methods were used to treat PWS, the clearance scores of patients were assessed for both methods, and the side effects were examined. Results: The mean age of the patients was 26.87 ±9.67 years. The majority of the patients (80%) were female. Thirty-four (56.66%) patients had PWS in the malar area, 14 (23.33%) on their forehead, 5 (8.33%) on their chin, and 7 (11.7%) on neck. The efficacy of the treatment through clearance score shows that the quantitative mean of the clearance score of the patients in the PDL method was 2.71 ±0.54, and in the CO2 + PDL method it was 2.72 ±0.56 (p > 0.05). The qualitative comparison of clearance scores indicated that in the PDL method, 18 (30%) patients had acceptable clearance, 30 (50%) patients had good clearance, and 12 (20%) patients had excellent clearance. Also, for the PDL plus CO 2 method, 25 (41.766) patients had acceptable clearance, 23 (38.34%) patients had good clearance, and 12 (20%) patients had excellent clearance. Conclusions: For PWS patients under treatment with PDL plus CO 2 , the hyperpigmentation side effect was greater than in patients with underlying PDL only.

Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

“…To address the potential impacts of skin phototypes or geographical regions on efficacies between studies, we extracted the PDL studies performed in Southeast Asia (N = 19) 28,39,42,44,45,53,54,57,59,60,62,63,66,67,73,75,76,78,80 where the populations have darker skin phototypes (Fitzpatrick II−IV). There was no significant difference between the mean CI from studies in each subgroup.…”

“…For the PDL‐related studies, 88 publications were excluded, including 78 other types of studies such as review papers, 3 where the full text was not available, 3 without quartile data available, 1 in non‐English, and 3 with more than one treatment modality under study. After screening, a total of 40 studies were eligible comprising 5094 patients 28,39,42–57,59–80 . The HMME–PDT studies were all performed in China where HMME was approved as a photosensitizer for PWB treatment by the appropriate governmental authorities.…”