Possible hazards of cryogen use with pulsed dye laser. A case report and summary.
BACKGROUND
Pulsed dye laser treatment of port-wine stains is safe and effective. However, the pain associated with this treatment is often difficult to tolerate, especially for children. A laser-coupled delivery system known as dynamic epidermal cooling has recently been developed to improve local anesthesia.


OBJECTIVE
To report laser ignition of a commercially-available, hand-held cryogen spray used for local anesthesia, and describe possible mechanisms of the fire; to define the chemical characteristics of other skin coolants suitable and unsuitable for skin cooling with laser treatment.


METHODS
Case report and literature review.


CONCLUSIONS
Clinicians must be aware of the thermodynamic properties, potential for skin damage, cost and environmental consequences of commercially available cryogens before considering their use for topical anesthesia with laser surgery.
White
J M
JM
School of Medicine, St. Louis University Health Sciences Center, Missouri, USA.
Siegfried
E
E
Boulden
M
M
Padda
G
G
D000772:Anesthesia, Local / Q000009:adverse effects*; D002648:Child; D005018:Ethyl Chloride / Q000009:adverse effects*; D005148:Facial Dermatoses / Q000601:surgery*; D005390:Fires; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D019339:Port-Wine Stain / Q000601:surgery*
D005018:Ethyl Chloride