Treatment response of port-wine stains with the flashlamp-pulsed dye laser in the National Skin Centre: a report of 36 patients.
This is a report of a prospective study on the treatment response of 36 patients with port-wine stains with the 585 nm flashlamp-pulsed dye laser and who have completed at least 1 year of follow-up. All patients received treatment at 8-weekly intervals under topical lidocaine-prilocaine anaesthesia. Most of the patients received at least 4 treatments in total. At the end of each treatment and on completion of treatment, patients were assessed for response based on a subjective scoring system where excellent is more than 75% improvement (lightening of redness), good is 50% to 75% improvement, fair is 25% to 75% improvement and poor is less than 25% improvement and the same is no observable improvement. The author and patients administered the scores after each treatment separately. The mean age was 26.1 years (range 2 years to 53 years). The mean initial energy density dose was 6.432 J/cm2. Most patients experienced significant improvement after the initial treatment and further improvements were observed with each subsequent treatment. The author generally recorded better improvement scores than the patients. Ninety percent of the patients were satisfied with the outcome of treatment. Only 11% of the patients scored the improvement after treatment as excellent, while the author scored 36% of the lesions treated as excellent improvement. More than two-thirds of the patients observed good to excellent improvements after the first treatment and by the fourth treatment, all patients recorded either good or excellent improvement. There were no statistically significant differences in treatment response in the various types (papular or macular) of lesions and skin colour type of patients. Light coloured port-wine stains tended to respond better to treatment than darker lesions (not statistically significant), but overall, all coloured lesions responded well to treatment. Patients' expectations of improvement were generally higher than those of the author.
Institute of Dermatology, National Skin Centre, Singapore.
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Goh
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D019339:Port-Wine Stain / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D012880:Skin Pigmentation; D016896:Treatment Outcome