Incidence of side effects in the treatment of telangiectasias by compression sclerotherapy: hypertonic saline vs. polidocanol.
Two of the most common side effects of sclerotherapy of leg veins are telangiectatic matting (TM), and postsclerosis hyperpigmentation. A random sample of 113 female patients with similar treatment sites of telangiectasias (less than 1 mm in diameter) and venulectasias of 1-2 mm diameter on the legs were treated by sclerotherapy and assessed at 1 and 6 months later for the presence of TM and hyperpigmentation. Patients received treatment with either 23.4% hypertonic saline (HS) alone (N = 74), 1% polidocanol (POL) alone (N = 21), or a comparison treatment with both HS and 1% POL (N = 18). A subgroup of patients received both 1% POL and 0.5% POL (N = 10). The incidence of hyperpigmentation was related both to vessel size and to sclerosing solution; only one patient showed hyperpigmentation in a vessel less than 1 mm, while in 1-2 mm vessels the incidence was 10.9% for HS and 30.7% for 1% POL (p less than .004) at 1 month. At 6 months postsclerotherapy, the incidence of pigmentation was 2% for HS and 7.5% for 1% POL. Both the type and concentration of sclerosing solution affected the incidence of TM; the incidence of TM was 33% for 1% POL, compared to only 13% for HS (p less than .004). At 6 months follow-up, the incidence of TM decreased to 2% for HS and 9% for 1% POL. Ten patients who developed TM with 1% POL were treated subsequently with 0.5% POL and demonstrated no matting. These data indicate that the incidence of side effects was affected by both the concentration and type of sclerosant.
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD.
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D005260:Female; D006801:Humans; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D011312:Pressure; D012462:Saline Solution, Hypertonic / Q000009:adverse effects* / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects* / Q000379:methods; D013684:Telangiectasis / Q000628:therapy*
D012462:Saline Solution, Hypertonic; D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols