-
Pediatric Dermatology Mar 2021Port-wine birthmarks (PWBs) are progressive vascular malformations with significant disfigurement and psychosocial morbidity; early light-based treatment has shown... (Review)
Review
Port-wine birthmarks (PWBs) are progressive vascular malformations with significant disfigurement and psychosocial morbidity; early light-based treatment has shown improved outcomes in the pediatric population. Somatic mosaic mutations underly the progressive nature of PWBs and explain the significant differences in response and heterogeneity of vessel architecture in the pediatric population when compared to the adult cohort. Here, we summarize a review of pediatric specific literature on the various light-based treatment modalities, including pulsed dye laser, near-infrared lasers, and intense pulsed light, providing the various indications, tips, advantages, and disadvantages for the pediatric dermatologist.
Topics: Adult; Child; Cohort Studies; Humans; Lasers, Dye; Low-Level Light Therapy; Port-Wine Stain; Treatment Outcome
PubMed: 33368674
DOI: 10.1111/pde.14503 -
Skin Research and Technology : Official... Aug 2023The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we...
INTRODUCTION
The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we gathered data from 10 years of experience regarding dye laser treatment of patients presenting vascular malformations such as telangiectasia, rhinophyma, port-wine stain, cherry and spider angioma and vascular tumours.
METHODS
Subjects were enrolled from 2013 to 2023 based on the vascular anomalies they presented. They underwent different treatment sessions with the FPDL device.
RESULTS
The age-range distribution by vascular anomaly confirmed that haemangiomas are typical in children while rhinophyma is a condition very common in older adults. A difference in sex distribution showed that pathologies such as telangiectasias typically affect women whereas rhinophyma is more frequent in men. Most of the treatments interested the face area but no permanent side effects were registered.
CONCLUSIONS
Our 10 years of experience with FPDL demonstrated good results in a wide range of applications for the treatment of different vascular anomalies. The absence of long-term side effects and bearable pain during the treatment makes it a valuable solution for the resolution of benign tumours also in very young patients.
Topics: Female; Humans; Male; Lasers, Dye; Retrospective Studies; Rhinophyma; Hemangioma; Vascular Malformations
PubMed: 37632184
DOI: 10.1111/srt.13427 -
Lasers in Surgery and Medicine Jan 2021To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia.
BACKGROUND AND OBJECTIVES
To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia.
STUDY DESIGN/MATERIALS AND METHODS
Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5-12 mm with fluences ranging from 8 to 18 J/cm . Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm ). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre-auricular area) for addition of RF energy just before the pulse (40-70 J/cm ) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow-up visits 1 and 3 months after the final treatment.
RESULTS
Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50-75% clearance, and 23% of lesions had 76-100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively.
CONCLUSION
An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Topics: Female; Humans; Laser Therapy; Lasers, Dye; Male; Middle Aged; Pigmentation Disorders; Rejuvenation; Telangiectasis; Treatment Outcome
PubMed: 32779273
DOI: 10.1002/lsm.23309 -
Journal of Cosmetic and Laser Therapy :... Nov 2021Noninvasive pulsed dye laser is the current gold standard for the treatment of port wine stains. However, most port wine stains are not completely cleared after pulsed... (Review)
Review
Noninvasive pulsed dye laser is the current gold standard for the treatment of port wine stains. However, most port wine stains are not completely cleared after pulsed dye laser therapy, owing to insufficient photocoagulation and laser-induced vascular regeneration and reperfusion. Several studies have explored approaches designed to improve treatment efficacy. This integrative literature review summarizes the results of clinical and animal studies published between 2004 and 2021. Pulsed dye laser has been administered in combination with photoelectric devices (the neodymium: yttrium-aluminum-garnet lasers, dual-wavelength 1064-/595-nm laser irradiation, fiberoptic Nd-YAG laser, photodynamic therapy, and radio frequency), and drugs (rapamycin, imiquimod, timolol, axitinib, endothelin receptor antagonist, artificial red blood cells and oxymetazoline). The initial results suggest that combination therapy is a direction worth exploring in the future. Further large prospective, blinded and controlled multicenter clinical trials with longer follow-up period are required to obtain more robust evidence.
Topics: Animals; Laser Therapy; Lasers, Dye; Lasers, Solid-State; Multicenter Studies as Topic; Phototherapy; Port-Wine Stain; Prospective Studies; Treatment Outcome
PubMed: 35422188
DOI: 10.1080/14764172.2022.2052901 -
Journal of Cosmetic Dermatology Jun 2022To evaluate the clinical efficacy and safety of 595-nm pulsed dye laser in the treatment of verruca vulgaris in children and to compare the efficacy of this method... (Clinical Trial)
Clinical Trial
OBJECTIVE
To evaluate the clinical efficacy and safety of 595-nm pulsed dye laser in the treatment of verruca vulgaris in children and to compare the efficacy of this method against two other methods, microwave tissue coagulation and liquid nitrogen cryotherapy.
METHODS
A total of 90 children being treated in the dermatology outpatient department of our hospital from 2019 to 2021 were selected and divided into three groups: the treatment group A (n = 30, treated with a 595-nm pulsed dye laser), treatment group B (n = 30, treated with microwave tissue coagulation), and treatment group C (n = 30, treated with liquid nitrogen cryotherapy). All the patients in the treatment group A, treatment group B, and treatment group C were treated once every two weeks, with a maximum of six treatments.
RESULTS
The response rate of the treatment group A was 93.3%, which was higher than the 83.3% rate of treatment group B and the 66.7% rate of treatment group C. The average treatment times of the treatment group A (2.45 ± 1.10) were lower than group B (3.51 ± 0.98) and group C (4.63 ± 0.96). The adverse reaction rate in the treatment group A (16.7%) was significantly lower than that in treatment group B (56.7%) and treatment group C (63.3%). The differences were statistically significant (all p < 0.05).
CONCLUSIONS
The 595-nm pulsed dye laser is safe and seems to be the most effective treatment for verruca vulgaris in children. Further high-level clinical trial is warranted to verify our results.
Topics: Child; Cryotherapy; Humans; Lasers, Dye; Microwaves; Nitrogen; Treatment Outcome; Warts
PubMed: 35357763
DOI: 10.1111/jocd.14951 -
Efficacy of 595- and 1319-nm pulsed dye laser in the treatment of acne vulgaris: a narrative review.Journal of Cosmetic and Laser Therapy :... Apr 2020Acne is one of the commonest problems of adolescence with almost half of the patients experiencing persistence into adulthood. Pulsed dye lasers (PDL) with wavelengths... (Review)
Review
Acne is one of the commonest problems of adolescence with almost half of the patients experiencing persistence into adulthood. Pulsed dye lasers (PDL) with wavelengths of 585 and 595 nm targeting hemoglobin have been used for the treatment of this condition and its sequelae. Recent introduction of PDL with a higher wavelength of 1319 nm has been reported to offer some benefit to acne patients. We reviewed the literature on the use of 595-nm and 1319-nm PDL in the management of acne. A PubMed literature search for search terms "pulsed dye laser," "acne laser therapy," "light therapy for acne," "595 nm and acne," "1319 nm and acne" was done. Studies, series and case reports were included. These lasers were compared to other lasers and light sources such as 532-nm Potassium Titanyl Phosphate laser, 585-nm PDLs, 1450-nm diode laser, 1540-nm erbium glass laser, intense-pulsed light (IPL), photodynamic therapy, red and blue light and short-pulsed 1064 nm laser utilized in acne management regarding their efficacy. Improvement in acne grading, scale severity or reduction in lesion count indicated substantial efficacy of the laser system utilized.
Topics: Acne Vulgaris; Adolescent; Humans; Laser Therapy; Lasers, Dye; Lasers, Solid-State; Photochemotherapy; Treatment Outcome
PubMed: 32516014
DOI: 10.1080/14764172.2020.1774063 -
Dermatologic Surgery : Official... Apr 2017Warts or verrucae vulgaris are common cutaneous infections with currently no definitive curative treatments available. (Review)
Review
BACKGROUND
Warts or verrucae vulgaris are common cutaneous infections with currently no definitive curative treatments available.
OBJECTIVE
To determine the efficacy of pulsed dye laser (PDL) in the treatment of warts.
MATERIALS AND METHODS
A literature search was performed using the PubMed and MEDLINE databases. A search using {(Wart[s], verruca or condylomata)} AND [(Pulsed dye laser)] was used. Forty-four articles were identified as relevant to this review.
RESULTS
Simple warts were very responsive to PDL, being treated successfully in over 95% of patients. Facial and anogenital warts also demonstrated excellent outcomes. Recalcitrant warts, displayed significant variability in their response, ranging between 50% and 100% across all articles. The response rates seen in peripheral warts (involving the hands and feet) were also very variable, ranging between 48% and 95%. Recurrence rates at 4 months of follow-up were documented as 0% to 15%. Complications have been described as very few and rare, the main ones being topical discomfort and erythema.
CONCLUSION
Pulsed dye laser is a safe and effective modality in the treatment of warts that can be applied to most body parts. Cost and availability remain a limitation to the use of PDL; however, this modality can be used when other more traditional and accessible treatments have failed.
Topics: Anus Diseases; Facial Dermatoses; Female; Foot Dermatoses; Genital Diseases, Female; Genital Diseases, Male; Hand Dermatoses; Humans; Lasers, Dye; Male; Warts
PubMed: 28272080
DOI: 10.1097/DSS.0000000000001023 -
QJM : Monthly Journal of the... Jun 2015Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Infantile hemangiomas (IH) are common pediatric tumors. This meta-analysis was performed to review the therapeutic efficacy and safety of pulsed dye laser (PDL) in the treatment of IH.
METHODS
Seven databases were searched, including PubMed, OvidSP, Karger, Elsevier, EMBASE, Web of Science and Wiley Online Library. The review collected the characteristics of year of publication, hemangiomas cases, prior treatment, laser parameters, adverse side, pretreatment symptom, and number of response from all articles.
RESULTS
A total of 1580 studies were identified, the first round search retrieved 39 articles met inclusion criteria. Of those, only 13 articles with 1529 hemangiomas were included in the meta-analysis. This meta-analysis demonstrated an overall resolution rate of 89.1% with 6.28% incidence of adverse effect.
CONCLUSION
PDL may be the effective modality to decrease the proliferative phase and accelerate rates of involution and resolution with few adverse events.
Topics: Female; Hemangioma; Humans; Infant; Lasers, Dye; Male; Skin Neoplasms; Treatment Outcome
PubMed: 25376585
DOI: 10.1093/qjmed/hcu206 -
Lasers in Medical Science Sep 2020Laser has been widely used in the treatment of vascular skin diseases, such as port wine stain, due to the effect of selective photothermolysis in laser on biological... (Comparative Study)
Comparative Study
Laser has been widely used in the treatment of vascular skin diseases, such as port wine stain, due to the effect of selective photothermolysis in laser on biological tissue. The 755 nm alexandrite laser was expected to achieve better curative effect than the commonly used 585 or 595 nm pulsed dye laser (PDL) because of its deeper tissue penetration. In this study, the dorsal chamber model and microscopic visualization system were used to observe morphology changes on 42 blood vessels before and after irradiation with the 755 nm laser. Results showed that thermal effects of blood vessels intensified with the increase in energy, and high energy was required to produce the same thermal effect as the extension of pulse width. Different from 595 and 1064 nm lasers, partial vessel contraction was dominant thermal effect caused by the 755 nm laser. The bleeding injury rate and thermal effect of the 755 nm laser were between those of 595 nm PDL and 1064 nm Nd:YAG laser. The simulation results proved that 595 nm PDLs were effective for small and shallow target blood vessels. The 755 nm alexandrite lasers were effective in the treatment of hypertrophic and resistant blood vessels to PDL in the skin with low or moderate melanin concentration. The 1064 nm Nd:YAG laser was effective in the treatment of deeply buried and enlarged target blood vessels in the skin with high melanin concentration. The simulation results were supported by published clinical observations.
Topics: Absorption, Radiation; Animals; Blood Vessels; Computer Simulation; Humans; Lasers, Dye; Lasers, Solid-State; Male; Mice; Numerical Analysis, Computer-Assisted; Port-Wine Stain; Skin; Temperature; Time Factors
PubMed: 32060655
DOI: 10.1007/s10103-020-02981-9 -
Cutis Jul 2020Acne vulgaris is one of the most common dermatologic diseases, ranging from comedonal or inflammatory papules to large, painful, disfiguring cysts. Numerous treatment... (Review)
Review
Acne vulgaris is one of the most common dermatologic diseases, ranging from comedonal or inflammatory papules to large, painful, disfiguring cysts. Numerous treatment approaches are available, each with their own risks and benefits that must be weighed when selecting the best option for an individual patient. Active-duty military servicemembers face additional levels of complexity when pursuing acne therapy. Untreated acne may interfere with their assigned duties, while various therapies also may limit their medical readiness and fitness for duty. We present a review of various acne treatment modalities with a focus on the military population. Additionally, we present a case in which the pulsed dye laser (PDL) was successfully used to treat inflammatory acne in an active-duty servicemember to highlight the use of PDL as an available and effective treatment option for acne in this population.
Topics: Acne Vulgaris; Dermatologic Agents; Humans; Lasers, Dye; Military Personnel; Treatment Outcome
PubMed: 32915930
DOI: 10.12788/cutis.0057