Initial lesion size as a predictive factor in determining the response of port-wine stains in children treated with the pulsed dye laser
J. G. Morelli, W. L. Weston, J. C. Huff and J. J. Yohn
Department of Dermatology, University of Colorado School of Medicine, Denver, USA.
OBJECTIVE: To evaluate the response of facial port-wine stains in children
to pulsed (450 microseconds) dye (577- or 585-nm) laser treatment based on
the age of the patient and the size of the port-wine stain at the
initiation of treatments. DESIGN: Case series. SETTING: Outpatient
dermatology clinic at the University of Colorado School of Medicine,
Denver. PATIENTS: A consecutive sample of 83 children who had facial
port-wine stains that were treated in their entirety at each visit.
INTERVENTION: Patients were treated with a pulsed (450 microseconds) dye
(577- and 585-nm) laser. MAIN OUTCOME MEASURE: Decrease in size of the
port-wine stain. RESULTS: Overall 18 (22%) of the 85 patients responded
with complete clearing of their port-wine stains. The port-wine stains in
32% (7/22) of the patients who began treatment before 1 year of age
responded with complete clearing of their port-wine stains compared with
18% (11/61) in older patients (P < .01). Fifteen (32%) of 47 patients
with port-wine stains smaller than 20 cm2 at initial evaluation were
totally cleared vs three (8%) of the 36 patients with port-wine stains
larger than 20 cm2 (P < .05). This size effect is apparent at all ages.
CONCLUSION: When considering treatment for facial port-wine stains with
pulsed dye lasers, it is important to consider not only the age of the
child at the beginning of treatments, but also the initial size of the
lesion.
