Refractory Port Wine Stains (PWS): Long Pulsed Alexandrite Laser as an Option

Abstract INTRODUCTION: Port wine stains (PWS) are congenital vascular malformations. Pulsed dye laser (PDL) is the treatment of choice till now, although many lesions do not respond completely. One of possible options is long pulsed alexandrite laser. Some literatures confirmed its efficacy. The aim of the present study is to determine the efficacy of this laser as an option in treating refractory PWS in Iranian patients.METHODS: Patients with refractory PWS lesions that did not respond to at least six PDL sessions were included if they had no history of Isotretinoin consumption in past year, history of keloid or hypertrophic scar formation, active infection in laser site and if they were not pregnant. All patients signed an informed consent. Alexandrite laser with fluencies from ۳۶-۴۰J/Cm۲, ۱۲ mm spot size, ۳ ms pulse duration and dynamic cooling device tuned to ۵۰/۵۰ ms was used in three successive sessions to treat lesions. All patients photographed before each session and after ۸ weeks from the last sessions. Then, pictures were rated by two blinded dermatologist rater to determine degree of response based of visual analog scaling from score ۱(below ۲۵% response) to score ۴ (more than ۷۵% response).RESULTS: A total of ۲۰ patients comprised of ۱۲ males and ۸ females with mean age of ۲۳ years were included. ۳۵% (۷ patients) had score of ۱, ۳۵% (۷ patients) had score of ۲, ۲۵% (۵ patients) had score of ۳ while one patient (۵%) reached score ۴. No serious side effect was observed. There was no significant relationship with age, gender and size of lesions and response rate.CONCLUSION: It seems that considering a conservative approach, long pulsed alexandrite laser may be an effective option in treating refractory PWS lesions. Although future studies with higher sample size using higher fluences are required to confirm these results. Keywords: hypersensitivity Nd YAG laser graphite