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Journal of Cosmetic and Laser Therapy :... Apr 2018Pulsed dye laser is the gold standard for port-wine stain (PWS) treatment. However, pulsed dye lasers achieve suboptimal clinical results in a majority of patients....
BACKGROUND
Pulsed dye laser is the gold standard for port-wine stain (PWS) treatment. However, pulsed dye lasers achieve suboptimal clinical results in a majority of patients. Patient demand for novel therapies and willingness to participate in clinical studies is currently unknown, yet, imperative for steering R&D activity. The objective of this study was to evaluate these two factors in relation to PWS patient demographics.
METHODS
A questionnaire was used to assess patient and PWS characteristics, treatment history, efficacy, and satisfaction, stress level, willingness to travel and pay for an effective treatment, participation in clinical studies, and amenability to intravenous drug administration. Descriptive statistics and correlation analysis were performed.
RESULTS
Of the respondents (N = 108), 65% would participate in clinical studies and 49% would accept intravenous drugs. For an effective treatment, 58% was prepared to pay over €2,000 and 48% would travel more than 6 h. Travel time was inversely correlated with age, clearance rate, and satisfaction. Facial PWS patients had undergone more treatments, were less satisfied, and less willing to participate in studies or accept intravenous drugs. Stress levels were higher in females.
CONCLUSION
There is considerable demand for new PWS therapies, and a substantial proportion of patients are willing to participate in clinical studies.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Lasers, Dye; Male; Middle Aged; Netherlands; Patient Preference; Patient Satisfaction; Port-Wine Stain; Prospective Studies; Research Subjects; Socioeconomic Factors; Stress, Psychological; Young Adult
PubMed: 29384394
DOI: 10.1080/14764172.2017.1368669 -
Dermatologic Surgery : Official... Oct 2018
Topics: Adult; Cosmetics; Drug Contamination; Female; Humans; Laser Therapy; Lasers, Dye; Port-Wine Stain; Staphylococcal Skin Infections; Superinfection
PubMed: 29381541
DOI: 10.1097/DSS.0000000000001428 -
Dermatologic Surgery : Official... Aug 1997Port-wine stains are congenital vascular malformations that can be disfiguring and may lead to psychosocial as well as medical complications. The 585-nm pulsed dye laser... (Review)
Review
BACKGROUND
Port-wine stains are congenital vascular malformations that can be disfiguring and may lead to psychosocial as well as medical complications. The 585-nm pulsed dye laser is very effective in treating port-wine stains. Laser treatment is often viewed by insurance companies as a "cosmetic procedure" and not "medically necessary". Consequently many patients are denied coverage for treatment of their disfiguring birthmarks.
OBJECTIVE
To determine variability of insurance coverage for laser treatment of port-wine stains from state to state. Natural history, progression, and potential complications of port-wine stains are reviewed and rationale for consistent insurance coverage for laser treatment of port-wine stains is given.
METHODS
A questionnaire was mailed to 40 dermatologic surgeons in 22 states and the District of Columbia. We reviewed the literature regarding port-wine stains and their potential complications, and health care policy guidelines regarding "medical necessity" and "cosmetic procedures".
RESULTS
Insurance coverage for laser treatment of port-wine stains varies from state to state.
CONCLUSION
Based on current health care policy guidelines, laser treatment of port-wine stains should be regarded, and covered, as a medical necessity by all insurance providers.
Topics: Age Factors; Dermatologic Surgical Procedures; Disease Progression; District of Columbia; Health Policy; Health Services Needs and Demand; Humans; Infant; Insurance Coverage; Insurance, Health; Laser Coagulation; Port-Wine Stain; Practice Guidelines as Topic; Skin; Surgery, Plastic; Surveys and Questionnaires; United States
PubMed: 9256913
DOI: 10.1111/j.1524-4725.1997.tb00386.x -
European Journal of Paediatric... May 2014Sturge-Weber syndrome is a rare sporadic neurocutaneous syndrome the hallmark of which is a facial port-wine stain involving the first division of the trigeminal nerve,... (Review)
Review
Sturge-Weber syndrome is a rare sporadic neurocutaneous syndrome the hallmark of which is a facial port-wine stain involving the first division of the trigeminal nerve, ipsilateral leptomeningeal angiomata and angioma involving the ipsilateral eye. Our understanding of the disease process has vastly improved since it was first described in 1879, with recent identification of an activating somatic mutation in the GNAQ gene found in association with both Sturge-Weber syndrome and non-syndromic facial port-wine stain. Sturge-Weber syndrome is marked by a variable but usually progressive course in early childhood characterised by seizures, stroke-like episodes, headaches, neurological and cognitive deterioration, hemiparesis, glaucoma and visual field defects. More recently, the increased prevalance of otolaryngological, endocrine and emotional-behavioural issues have been established. Neurophysiology and neuroimaging studies provide information regarding the evolution of changes in Sturge-Weber syndrome over time. Early recognition and aggressive management of symptoms remains cornerstone in the management of this syndrome. An international collaborative effort is needed to maximise our understanding of the natural history and response to interventions in Sturge-Weber Syndrome.
Topics: Brain; Headache; Humans; Neurocutaneous Syndromes; Port-Wine Stain; Seizures; Sturge-Weber Syndrome
PubMed: 24275166
DOI: 10.1016/j.ejpn.2013.10.003 -
Dermatologic Surgery : Official... Jul 2020
Topics: Adult; Facial Dermatoses; Female; Humans; Hypertrophy; Laser Therapy; Port-Wine Stain; Ultrasonic Therapy
PubMed: 30913052
DOI: 10.1097/DSS.0000000000001941 -
Dermatologic Surgery : Official... Aug 2001Port-wine stain (PWS) is a congenital vascular malformation of the superficial dermal vessels. These vessels become progressively ectatic, with development of nodular...
BACKGROUND
Port-wine stain (PWS) is a congenital vascular malformation of the superficial dermal vessels. These vessels become progressively ectatic, with development of nodular and hypertrophic areas on the surface of the lesions.
OBJECTIVE
To determine the efficacy of CO2 laser vaporization in the treatment of nodules in PWS.
METHODS
Twenty adult patients with PWS who developed nodules and hypertrophy on the surface of the lesions were treated by CO2 laser vaporization. Only one pass was performed to each area of the lesions, using a continuous and defocused mode, with a power density of 10 W/cm2. When the treated lesion was very large, several sessions of treatment were necessary to vaporize its entire surface. Photographic controls were performed before and after treatment.
RESULTS
The nodules and hypertrophy were removed and the smooth surface of the lesions was reestablished. The color, usually violaceous, was transformed in a slight erythema.
CONCLUSION
CO2 laser is a good method for treatment of nodules and hypertrophy in PWS. With adequate precautions, excellent cosmetic results can be obtained. Other more-specific laser systems may be successively used to treat the remaining erythema.
Topics: Adult; Aged; Female; Humans; Hypertrophy; Laser Therapy; Male; Middle Aged; Port-Wine Stain
PubMed: 11493291
DOI: 10.1046/j.1524-4725.2001.00219.x -
Photodermatology, Photoimmunology &... Jul 2021
Topics: Humans; Port-Wine Stain; Psoriasis; Treatment Outcome; Ultraviolet Therapy
PubMed: 33377191
DOI: 10.1111/phpp.12651 -
Journal of the American Academy of... Nov 1996A port-wine stain is a congenital vascular anomaly caused by a malformation of the papillary dermal capillaries. We observed three children with an unusual appearance of...
A port-wine stain is a congenital vascular anomaly caused by a malformation of the papillary dermal capillaries. We observed three children with an unusual appearance of their port-wine stains. All had a prominent inflammatory component consisting of scaling, excoriations, oozing, and crusting, resembling a dermatitis. In two patients, the port-wine stain occurred on the nape of the neck; in the third, it occurred over the occipital area of the scalp. Treatment with topical steroids helped to decrease the scaling and crusting, but when the steroids were stopped the inflammatory component returned. In tow patients, the lesions were treated with the flashlamp-pumped pulsed dye laser with almost total clearing of the port-wine stains and complete absence of the inflammatory component after one treatment. The recognition of this inflammatory manifestation of port-wine stains will enable earlier diagnosis and allow for effective treatment with the pulsed dye laser.
Topics: Dermatitis; Female; Humans; Infant; Neck; Port-Wine Stain; Scalp
PubMed: 8912592
DOI: 10.1016/s0190-9622(96)90090-0 -
European Journal of Dermatology : EJD Apr 2013
Topics: Disease Progression; Female; Humans; Hypertrophy; Lasers, Dye; Male; Middle Aged; Port-Wine Stain; Skin
PubMed: 23608049
DOI: 10.1684/ejd.2013.1998 -
Journal of Cosmetic Dermatology Mar 2023Acquired port-wine stains (APWS) are rare vascular malformations that share the same clinical and histological features as their congenital counterparts. Rare cases of... (Review)
Review
BACKGROUND
Acquired port-wine stains (APWS) are rare vascular malformations that share the same clinical and histological features as their congenital counterparts. Rare cases of AWPS secondary to trauma or in association with medications have been reported in the literature.
PATIENTS AND METHODS
We report two cases of APWS. One case appeared at the age of 2 months, the earliest reported in the literature and continued to evolve till the age of 3 years presenting with multifocal distribution mainly affecting the lower face. The second case developed during oral isotretinoin intake and persisted after discontinuation of the treatment.
RESULTS AND CONCLUSIONS
The second patient declined treatment, but the first patient had a remarkable improvement following treatment with the pulsed dye laser, which remains the standard of care for capillary malformations on the face.
Topics: Humans; Infant; Port-Wine Stain; Lasers, Dye; Treatment Outcome
PubMed: 36409504
DOI: 10.1111/jocd.15526