Objectives: To understand the laser treatment of port-wine stain using pulsed dye laser and alexandrite laser

Introduction: Laser treatment of port-wine stains was first developed in 1960s and the risks of scarring and texture changes were very common in early days. In 1983, the concept of selective photothermolysis revolutionized laser treatment of vascular lesions. According to the principle of selective photothermolysis, the pulse duration of laser light should be equal to or less than the thermal relaxation time of target vessel in order to maximize laser energy deposition within the vessel and to confine thermal damage to the treated vessel. Since then, the pulsed dye laser has become the gold standard.

Materials / method: Improved efficacy in PWS treatment is expected by utilizing variable wavelengths, variable pulse durations, higher energy fluences with selective skin cooling, and techniques such as pulse stacking in early age. PWS patients treated using long-pulse pulsed dye laser. Longer pulse durations and higher fluences with skin cooling are required for larger vessels.

Results: The ineffective response of PWS to the conventional PDL is due to the sub-optimal irradiation parameters of energy fluence and pulse duration currently used in clinical settings.

Conclusion: New generation PDL are more effective than conventional PDL, whereas controversy still exists as to which wavelength induces greater photothermal damage to the blood vessels in PWS. Long pulsed alexandrite is also available PWS, especially hypertrophic and or nodule PWS.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: This presentation provides an overview of the treatment of vascular lesions in patients with skin of colour. Variation in treatment protocol is needed to avoid complication due to different skin reactions and risk of complications.

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Materials / method: The pulsed dye laser remains the gold standard for treating vascular lesions such as portwine stain, haemangioma, telangiectasia, angioma, venous lake, facial erythema in rosacea, poikiloderma and leg veins. The other includes the long pulsed Nd:YAG (1064nm), Alexandrite (755nm) lasers. The IPL has also be used to treat superficial capilaries. The use of vascular lasers on skin of colour poses a challenge because of the darker skin type has a tendency to develop PIH and keloids.

Results: PDL emits a wavelength of 585/595nm which is preferentially absorbed by oxy-hemoglobin. The availability of larger spot sizes improved the penetration and reduces scattering effect and allows for better clinical effect and shorter treatment time.

Conclusion: Careful selection of wavelengths, larger spot size, pulsed duration and skin cooling devices have enable reduction of complications from vascular lesion in patients with skin of colour

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: To determine the feasibility, safety, and tolerability of Microfocused ultrasound (MFU) as a treatment option for vascular malformations (VMs).

Introduction: Current treatments options for vascular malformations (VMs) are invasive procedures associated with significant risk of morbidity and complications. Microfocused ultrasound (MFU) may provide a non-invasive novel alternative for the treatment of VMs.

Materials / method: An open-labeled, prospective, quasi-experimental study was done in patients with histologically-proven VMs consulting at the Jose R. Reyes Memorial Medical Center Department of Dermatology. Baseline photographs, length, and doppler ultrasound to measure depth and volume of the VMs were taken. MFU was applied on the VMs using at least two treatment depths with appropriate parameters based on the depth and length of the lesion. A total of three sessions at four-week intervals were done. Primary outcomes measure the depth and volume reduction of the treated area by doppler ultrasound.

Results: Preliminary results of this study includes 5 patients who have completed three treatment sessions. (2 verrucous hemangioma; 3 lymphangioma circumscriptum). There was a significant reduction in volume and depth after the treatment sessions. Global assessment scale scoring showed there was marked improvement (>50-75%) at week 16. Clinical photographs showed an over-all minor improvement (0-25%) in size at week 12 and week 16. All subjects developed at least mild side effects which include transient, tolerable pain and mild erythema.

Conclusion: MFU may be a feasible, tolerable, and safe non-invasive treatment option for VMs.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability