Long-pulsed 1064 nm Nd:YAG laser improves hypertrophic port-wine stains

Authors

  • A.M. van Drooge,

    Corresponding author
    1. Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Center, University of Amsterdam
    2. Department of Dermatology, Academic Medical Center, University of Amsterdam
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  • B. Bosveld,

    1. Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Center, University of Amsterdam
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  • J.P.W. van der Veen,

    1. Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Center, University of Amsterdam
    2. Department of Dermatology, Academic Medical Center, University of Amsterdam
    3. The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands
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  • M.A. de Rie,

    1. Department of Dermatology, Academic Medical Center, University of Amsterdam
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  • A. Wolkerstorfer

    1. Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Center, University of Amsterdam
    2. Department of Dermatology, Academic Medical Center, University of Amsterdam
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  • Preliminary results were previously presented at the 2008 ASLMS, Florida, USA.

  • Conflict of interest
    The authors have no conflict of interest to declare.

  • Funding sources
    None declared.

Abstract

Background  Hypertrophic port-wine stains (PWS) usually respond poorly to pulsed dye laser treatment. The long-pulsed 1064 nm Nd:YAG laser can target deeper situated vessels and may therefore be more effective.

Objective  To evaluate the efficacy and safety of the Nd:YAG laser for the treatment of hypertrophic PWS.

Methods  In a retrospective cohort study, all hypertrophic PWS patients treated with the Nd:YAG laser between 2005 and 2011 were invited for follow-up. Clinical improvement was assessed using Physician Global Assessment (PhGA) and Patient Global Assessment (PGA).

Results  Assessment was obtained in 32 of 44 eligible patients (mean age 51.4 years), after a mean of 2.8 (SD ± 2.1) Nd:YAG laser treatments. Good or excellent improvement of hypertrophy was found in a majority of patients, both by PhGA (91%) and PGA (93%). Good or excellent improvement of colour was found in 63% of patients by PhGA, and in 87% by PGA. Recurrence of hypertrophy was seen in three patients. All but two patients would recommend Nd:YAG treatment to other patients. Mild to moderate scars were seen in seven patients, hypopigmentation in 14 patients.

Conclusion  The 1064 nm Nd:YAG laser is highly effective in the treatment of hypertrophic PWS with only a few treatments needed. Mostly mild side effects were seen in half of all patients. Hypertrophy seems to respond better than colour. To further improve colour, a combination with pulsed dye laser treatment is advisory. Observation of immediate clinical endpoints is important when using the Nd:YAG laser, to optimize outcomes and reduce side effects.

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