Redarkening of Port-Wine Stains 10 Years after Pulsed-Dye–Laser Treatment

Huikeshoven, Menno; Köster, P.; Borgie, Corianne A. J. M. de; Beek, Hans van; Gemert, Martin J. C. van; Horst, Chantal M.A.M. van der

doi:10.1056/nejmoa064329

Cited by 141 publications

(83 citation statements)

References 14 publications

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“…Various types of lasers are used in oncology to debulk tumors, using both selective and ablative methods [4][5][6][7][8]. Pulsed dye laser (PDL) has been used to selectively target tumor vasculature with success in treating glottal dysplasia and squamous cell carcinoma in situ using 585 nm PDL [4,8].…”

Section: Introductionmentioning

confidence: 99%

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Shah

Konnikov²,

Duncan

et al. 2009

Lasers Surg Med

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Background and Objective: Basal cell carcinomas (BCCs) have supporting vasculature that could serve as a target for 595 nm pulsed dye laser (PDL). The objective of this study was to determine the effect of repeated PDL treatments on BCCs of superficial and nodular subtypes and of varying diameters. Study Design/Materials and Methods: Twenty biopsyproven BCCs received four 595 nm PDL treatments at 2-week intervals. The tumor and 4 mm of peripheral skin were treated using a set of previously optimized laser parameters: one pass, 15 J/cm 2 energy, 3 ms pulse length, no cooling, and 7 mm spot size with 10% overlap. The treated area was excised and evaluated histologically for residual tumor. Histologic response rates of the PDL treated BCCs were compared with that of non-PDL treated, matched control tumors. Results: Nearly all BCCs <1.5 cm in diameter (n ¼ 12) showed complete response to four PDL treatments (91.7%; n ¼ 11/12) versus 16.7% of controls (n ¼ 2/12, P-value ¼ 0.0003). BCCs !1.5 cm in diameter (n ¼ 8) showed a complete response rate of 25% (n ¼ 2/8) versus 0% of controls (n ¼ 0/8, P-value ¼ 0.2). Mean clinical tumor diameter of the complete responders was 1.1 cm (n ¼ 13) versus 2.2 cm (n ¼ 7) for incomplete responders (P-value ¼ 0.005). Tumor histologic types among the complete responders included superficial, nodular, micronodular, and keratinizing. Incompletely responding BCCs showed a significant reduction in tumor burden after PDL treatment, with residual histologic tumor burden ranging from <1% to 29% of the original clinical tumor diameter, compared to 13-68% residual tumor burden for the corresponding controls (P-value ¼ 0.05). Conclusions: PDL is an effective means of reducing tumor burden in patients with large BCCs and may be an alternative therapy in BCCs <1.5 cm in diameter.

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Section: Introductionmentioning

confidence: 99%

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Shah

Konnikov²,

Duncan

et al. 2009

Lasers Surg Med

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“…1), 14,15 and have been applied successfully in the determination of laser treatment efficacy in PWS lesions. 16 Clinically relevant, objective information may be determined from skin color measurements through the inverse application of a skin model. This method begins by creating a mathematical skin model through which light transport is simulated.…”

Section: Introductionmentioning

confidence: 99%

Simulating light transport through skin for color prediction of port wine stain lesions: a review

2012

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Abstract. A survey of the literature is presented regarding the simulation of port wine stain (PWS) skin color. Knowledge of PWS features, such as the depths and diameters of affected vessels, is essential for informing laser treatment. These may be determined through the inverse application of a skin model. The techniques which have been applied to achieve this are analyzed in detail. Radiative transfer (RT) is found to be the preferred method of simulation. By far the most common approximations to RT are the diffusion approximations, which have been applied successfully in the past and Monte Carlo techniques, which are now the methods of choice. As the requirements for improvement of laser treatment on an individual basis continues, the needs for further work towards accurate estimations of individual optical coefficients and robust, flexible simulation techniques are identified.

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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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Redarkening of Port-Wine Stains 10 Years after Pulsed-Dye–Laser Treatment

Abstract: Using objective color measurements, we observed significant redarkening of port-wine stains at long-term follow-up after pulsed-dye-laser therapy. Patients should be informed about the possibility of redarkening before beginning treatment.

Cited by 141 publications

References 14 publications

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

The effect of 595 nm pulsed dye laser on superficial and nodular basal cell carcinomas

Simulating light transport through skin for color prediction of port wine stain lesions: a review

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

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