Treatment of recalcitrant port-wine stains (PWS) using a combined pulsed dye laser (PDL) and radiofrequency (RF) energy device - 18/04/17
, Hamad Alabdulrazzaq, MD b, Jeremy A. Brauer, MD a, b, Roy G. Geronemus, MD a, bAbstract |
Background |
Pulsed dye laser (PDL) is the treatment of choice for port-wine stains (PWS). Some PWS are recalcitrant to this modality. A number of reasons for PDL treatment resistance have been described, including inadequate heat generation.
Objective |
We evaluated PDL combined with radiofrequency (RF) energy into a single device to target larger and deeper blood vessels and overcome PDL resistance.
Method |
This was an open-label, prospective, single-center investigation of a novel device combining RF energy with PDL conducted to treat recalcitrant PWS. Ten patients with 11 recalcitrant PWS were enrolled. Each PWS was divided into 5 treatment areas: PDL alone, RF alone, PDL+RF, RF+PDL, and untreated control. Patients underwent a maximum of 6 treatments, scheduled 4 to 6 weeks apart with follow-up evaluation at 4 and 12 weeks after the final treatment. Colorimetry and standardized digital photography were performed at all visits. Lesional biopsy specimens were collected for selected patients.
Results |
Areas treated with RF followed by PDL and PDL followed by RF showed the greatest improvement based on blinded review of digital photographs, reaching statistical significance (P value < .05) at the 12-week follow-up evaluation when compared with baseline. Adverse events, including purpura, erythema, edema, scabbing, crusting, and blistering, resolved without sequelae; a small residual scar was noted in 1 patient.
Limitations |
Small sample size and short follow-up period are limitations.
Conclusion |
Combined RF/PDL technology is promising for the treatment of recalcitrant PWS.
Le texte complet de cet article est disponible en PDF.Key words : cutaneous laser, pulsed dye laser, radiofrequency, recalcitrant port-wine stains
Abbreviations used : PDL, PWS, RF
Plan
| This work was made possible by an equipment loan from Syneron/Candela. |
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| Disclosure: Dr Bae is on the medical advisory board for Allergan and Merz, and is a consultant for Allergan, BioSpecifics, Merz, Galderma, and Cynosure/Palomar. Dr Brauer is a consultant with Miramar and received honoraria from Cynosure/Palomar. Dr Geronemus received honoraria from Cynosure/Palomar; owns stock or stock options for Zeltiq and OnLight Sciences; and sits on medical advisory boards for Zeltiq, Syneron/Candela, and Cynosure/Palomar. Dr Alabdulrazzaq has no conflicts of interest to declare. |
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| Reprints not available from the authors. |
Vol 76 - N° 2
P. 321-326 - février 2017 Retour au numéro
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