Hypertrophy in port-wine stains: Prevalence and patient characteristics in a large patient cohort

Drooge, Anne Margreet van; Beek, Hans van; Veen, J.P.W. van der; Horst, Chantal M.A.M. van der; Wolkerstorfer, Albert

doi:10.1016/j.jaad.2012.05.027

Cited by 75 publications

(57 citation statements)

References 24 publications

(25 reference statements)

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“…Despite the variability in incidence and age at onset, most authors agree that increasing age is strongly correlated with increased incidence of hypertrophic PWS. No significant association has been found between size or location and the development of hypertrophy 22 . PWS thickness, as a function of anatomical location or age, is directly correlated with increasing resistance to PDL treatment.…”

Section: Mechanisms Of Resistancementioning

confidence: 83%

“…As the patient ages, PWS increase in both size and thickness, often becoming hypertrophic and/or nodular. The incidence of hypertrophic and nodular lesions has been reported between 10% and 40% with a median age at onset ranging from 20 to 39 years for hypertrophy, 39 years for nodules and as early as 12 years for the onset of diffuse thickening 2,20–22 . Despite the variability in incidence and age at onset, most authors agree that increasing age is strongly correlated with increased incidence of hypertrophic PWS.…”

Section: Mechanisms Of Resistancementioning

confidence: 99%

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Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment

et al. 2013

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Port-wine stains (PWS) are among the most common congenital vascular malformations. Unlike capillary haemangiomas, these lesions do not involute spontaneously but rather become progressively more disfiguring as the patient ages. While benign in nature, the cosmetic deformity and attendant psychological and emotional distress prompt the majority of those afflicted to seek treatment. The pulsed dye laser (PDL) has long been considered the treatment of choice for these vascular lesions; however, very few patients achieve total clearance with PDL therapy and a significant number of lesions fail to respond at all. In order to address these recalcitrant cases, the mechanisms that contribute to treatment resistance must be understood and novel laser and light therapies must be employed. This review will address what is currently known about lesion-specific characteristics of PDL-resistant PWS as well as discuss current and future treatment options.

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Section: Mechanisms Of Resistancementioning

confidence: 83%

Section: Mechanisms Of Resistancementioning

confidence: 99%

Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment

et al. 2013

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“…It affects roughly 0.3–0.5% newborns . A hypertrophic stage may begin in early 30’ so that it is hypertrophic in most patients older than 50 years . The mainstay of PWS treatment has been LPDL.…”

Section: Treatment Of Different Vascular Lesionsmentioning

confidence: 99%

“…132 A hypertrophic stage may begin in early 30' so that it is hypertrophic in most patients older than 50 years. 133 The mainstay of PWS treatment has been LPDL. Complete resolution is a rare event and almost 20% of lesions are resistant to further LPDL treatment (a plateauing effect is seen after 7-10 sessions).…”

Section: Infantile Haemangiomasmentioning

confidence: 99%

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Adamič¹,

Pavlović

Rubin

et al. 2015

Acad Dermatol Venereol

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Aim Lasers and non-coherent intense pulse light sources (IPLS) are based on the principle of selective photothermolysis and can be used for the treatment of many vascular skin lesions. A variety of lasers has been developed for the treatment of congenital and acquired vascular lesions which incorporate these concepts into their design. Although laser and light sources are very popular due to their non-invasive nature, caution should be considered by practitioners and patients to avoid permanent side-effects. The aim of these guidelines is to give evidence-based recommendations for the use of lasers and IPLS in the treatment of vascular lesions. Results Lasers and IPLS are very useful and sometimes the only available method to treat various vascular lesions. It is of a paramount importance that the type of laser or IPLS and their specific parameters are adapted to the indication but also that the treating physician is familiar with the device to be used. The crucial issue in treating vascular lesions is to recognize the immediate end-point after laser treatment. This is the single most important factor to ensure both the efficacy of the treatment and avoidance of serious side-effects. Methods Conflicts of interestNone declared. Funding sourceNone.Since the publication of previous European Society of Laser Dermatology (ESLD) guidelines in 2007, there have been significant advances in the field of laser treatment of common vascular lesions.1 These guidelines have been updated by the Consensus Panel under the auspices of the ESLD. Methodology, search strategy and recommendation formulation are described in Appendix II. A brief overview of vascular lasersStandard vascular lasers include pulsed dye lasers (585 and 595 nm), and KTP-lasers (532 nm), followed by longer wavelength lasers such as alexandrite lasers (755 nm), diode lasers (800-900 nm) and millisecond Nd:YAG lasers (1064 nm). New developments include a non-uniform pulse sequence or a dual-wavelength modality (combined dual wavelength 595 and 1064 nm-pulsed dye and Nd:YAG laser) and microsecond Nd: YAG lasers. [2][3][4][5][6] Even fractional photothermolysis has begun to be used for selected vascular lesions. Lasers' and intense pulse light sources (IPLS) effects are based on the principle of selective photothermolysis. In general, they deliver a precisely graded aliquot of energy to a defined area of the skin in a reproducible, standardized manner that almost always involves addition or evacuation of heat. The greatestThe first two authors have contributed equally to the manuscript.

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“…Port‐wine stain (PWS) is a congenital capillary malformation that occurs in 0·3% of newborns . PWS lesions are usually flat and pink at the beginning, and become nodular, hypertrophic, or darker with age . The majority of PWS (70%) are located on the face and neck area and therefore can cause physical and psychosocial problems …”

mentioning

confidence: 99%

Prospective comparison treatment of 595-nm pulsed-dye lasers for virgin port-wine stain

Qiu

et al. 2015

Br J Dermatol

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Hypertrophy in port-wine stains: Prevalence and patient characteristics in a large patient cohort

Cited by 75 publications

References 24 publications

Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment

Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment

Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology

Prospective comparison treatment of 595-nm pulsed-dye lasers for virgin port-wine stain

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