Efficacy of early treatment of facial port wine stains in newborns: A review of 49 cases

✍ Scribed by Anne M. Chapas; Kimberly Eickhorst; Roy G. Geronemus

• Book ID: 102468980
• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 137 KB
• Volume: 39
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.20529

✦ Synopsis

Abstract

Background

Port wine stains (PWS) affect 0.3–0.5% of both sexes of newborns, usually occurring on the face.

Objective

To document safety and effectiveness of cryogen spray cooled, pulsed‐dye laser at higher fluences than previously used to lighten facial PWS in infants ≤6 months, and establish that frequent treatment early in life yields better clearance than if delayed until later in life.

Materials and Methods

Forty‐nine infants who had been treated with pulsed‐dye laser treatments for facial PWS at ≤6 months were identified by case review of photographs, age, sex, PWS severity score prior to laser treatment, number of treatments, and improvement following laser therapy.

Results

Patients averaged 9.3 (range 2–16) treatments at 4–6 week intervals at 7.75–9.5 J/cm^2^. Average surface area treated was 24.0% with 88.6% average clearance after 1 year. Average clearance was 90.7% for lesions covering <20% surface area and 85.6% for lesions ≥20%. Location (V1, V2, V3, eye, and/or scalp), treated surface area, treatment number, and fluence predicted clearance. Average clearance for sole involvement of V1 was highest (at 93.8%), followed by V2 (at 91.1%), V3 (at 84.3%), V1/V2 (at 83.7%), V1/V2/V3 (at 81.0%), periocular (at 88.6%), and scalp (at 89.9%). All patients tolerated the higher treatment fluences without atrophy or scarring.

Discussion/Conclusions

Frequent, high energy pulsed‐dye laser treatments are safe and highly effective in improving facial PWS in infants ≤6 months of age. Patients with PWS should be referred for pulsed‐dye laser treatment during early infancy. Lesers Surg. Med. 39:563–568, 2007. © 2007 Wiley‐Liss, Inc.