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Treatment of Port-Wine Stain Birthmarks Using the 1.5-msec Pulsed Dye Laser at High Fluences in Conjunction with Cryogen Spray Cooling

Authors

  • Kristen M. Kelly MD,

    1. Departments of Surgery and
    2. Dermatology, Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California
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  • Vandana S. Nanda MD,

    1. Departments of Surgery and
    2. Dermatology, Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California
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  • J. Stuart Nelson MD, PhD

    1. Departments of Surgery and
    2. Dermatology, Beckman Laser Institute and Medical Clinic, University of California, Irvine, Irvine, California
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  • K.M. KELLY, MD, V.S. NANDA, MD, AND J.S. NELSON, MD, PHD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Address correspondence and reprint requests to: Kristen M. Kelly, MD, Beckman Laser Institute, University of California, Irvine, 1002 Health Sciences Rd. E, Irvine, CA 92612.

Abstract

Background. The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy.

Objective. To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling.

Methods. Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis.

Results. No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50–74% blanching, 20% achieved 25–49% blanching, and 30% achieved less than 25% blanching.

Conclusion. In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous.

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