Port-wine Stains: An Assessment of 5 Years of Treatment

Orten, Steven S.; Waner, Milton; Flock, Stephen Thomas; Roberson, Paula K.; Kincannon, Jay

doi:10.1001/archotol.1996.01890230022005

Cited by 131 publications

(78 citation statements)

References 9 publications

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“…By proper selection of pulse duration ( p ) and wavelength (), thermal energy remains confined to the targeted vasculature. These therapies have proven effective [2][3][4][5][6] ; however, multiple treatments are often required, and complete clearing of the lesion is not always achieved, 6 especially in patients with large-diameter vessels and extensive vasculature that extends deep within the dermis. 7 Incomplete clearing of the lesion may be due to insufficient heat generation within the targeted vasculature, which is affected by pulse duration ( p ), wavelength (), and radiant exposure (D 0 injury per treatment session, ultimately leading to a decreased number of treatments required for successful clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

Effects of Cryogen Spray Cooling and High Radiant Exposures on Selective Vascular Injury During Laser Irradiation of Human Skin

Tunnell¹,

Chang²,

Johnston³

et al. 2003

Arch Dermatol

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Section: Discussionmentioning

confidence: 99%

Effects of Cryogen Spray Cooling and High Radiant Exposures on Selective Vascular Injury During Laser Irradiation of Human Skin

Tunnell¹,

Chang²,

Johnston³

et al. 2003

Arch Dermatol

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“…When the combined approach is used, might lower laser light dosages be more successful thereby making PWS therapy not only more effective, but also safer? It is also hoped that the increased efficacy of PDL when used in conjunction with angiogenesis inhibitors will reduce the occurrence of PWS darkening that can appear many years after PDL treatment [12][13][14]. Revascularization in the deeper parts of the PWS is likely responsible for such observed lesion recur- rence.…”

mentioning

confidence: 99%

Can the wound healing response of human skin be modulated after laser treatment and the effects of exposure extended? Implications on the combined use of the pulsed dye laser and a topical angiogenesis inhibitor for treatment of port wine stain birthmarks

et al. 2008

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“…Otro aspecto que debe tenerse en cuenta es la posibilidad de recidiva o de empeoramiento de la mancha en vino de Oporto una vez concluido el tratamiento, hecho que puede verse hasta en un 15% de los casos 47,48 . Para aquellos pacientes que después de varias sesiones ya no se detecte una respuesta clínica evidente es aconsejable de todas formas realizar periódica-mente una sesión, con una frecuencia anual por ejemplo, para evitar la progresión de la enfermedad, ya que las manchas en vino de Oporto tienden por su comportamiento natural a oscurecerse con el tiempo y a engrosar la piel, adoptando una…”

Section: Malformaciones Capilaresunclassified

Láser y luz pulsada intensa en el tratamiento de hemangiomas infantiles y malformaciones vasculares

Sánchez‐Carpintero

Mihm

Waner

2004

Anales Sis San Navarra

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RESUMENEl uso de las indicaciones del láser en el manejo de las malformaciones vasculares y los hemangiomas infantiles se fundamenta en la teoría de la fototermolisis selectiva, siendo la oxihemoglobina el cromóforo diana sobre el cual actúa la luz del láser, evitándose así el daño a tejidos vecinos. El láser de colorante pulsado es el más utilizado y es, actualmente, el tratamiento de elección en las malformaciones capilares (mancha en vino de Oporto). La respuesta obtenida es variable, alcanzándose un aclaramiento sustancial del color de la lesión, tras varias sesiones. La aplicación en edades tempranas parece mejorar los resultados. Las malformaciones venosas, especialmente las localizadas en la mucosa, responden mejor al láser de Nd:YAG; las malformaciones linfáticas al láser de CO 2 . Las malformaciones arteriovenosas raramente responden. El uso del láser de colorante pulsado en la fase proliferativa de los hemangiomas es controvertido, excepto si existe ulceración. En estos casos se obtiene una reepitelización rápida tras su empleo. En la fase involutiva, los pacientes con lesiones residuales vasculares pueden beneficiarse de otros láseres como KTP o Nd:YAG. Si presentan superficie atrófica y cicatrices mejoran con láser de CO 2 o Er:YAG. Están emergiendo nuevas modalidades como la terapia fotodinámica cuya eficacia y seguridad, tanto en el tratamiento de los hemangiomas como de las malformaciones vasculares, está aún por confirmar. ABSTRACTThe use of the indications of the laser in treating vascular malformations and infantile haemangiomas is based on the theory of selective photothermolysis, in which the oxyhaemoglobin is the target chromophore on which the light of the laser acts, thus avoiding damage to neighbouring tissues. The pulsed dye laser is the most employed and at present is the treatment of choice in capillary malformations (port-wine stains). A variable response is obtained, with a substantial clearing of the colour of the lesion after several sessions. Application at early ages seems to improve the results. Venous malformations, especially those localised in the mucosa, respond better to the Nd:YAG laser; lymphatic malformations to the CO2 laser. Arteriovenous malformations rarely respond. Use of the pulsed dye laser in the phase of proliferation of the haemangiomas is subject to controversy, except where there is ulceration. A rapid re-epithelialization is obtained in these cases following its use. In the involution phase, patients with residual vascular lesions can benefit from other lasers such as KTP or Nd:YAG. If they show an atrophic surface and scars these complications improve with the CO2 laser or Er:YAG. New treatment modalities are emerging, such as photodynamic therapy, whose efficacy and safety, both in the treatment of haemangiomas and vascular malformations, have yet to be confirmed.

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Port-wine Stains: An Assessment of 5 Years of Treatment

Cited by 131 publications

References 9 publications

Effects of Cryogen Spray Cooling and High Radiant Exposures on Selective Vascular Injury During Laser Irradiation of Human Skin

Effects of Cryogen Spray Cooling and High Radiant Exposures on Selective Vascular Injury During Laser Irradiation of Human Skin

Can the wound healing response of human skin be modulated after laser treatment and the effects of exposure extended? Implications on the combined use of the pulsed dye laser and a topical angiogenesis inhibitor for treatment of port wine stain birthmarks

Láser y luz pulsada intensa en el tratamiento de hemangiomas infantiles y malformaciones vasculares

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