title: Treatment of port-wine stain birthmarks using the 1.5-msec pulsed dye laser at high fluences in conjunction with cryogen spray cooling.
abstract: BACKGROUND
  The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy.
  
  
  OBJECTIVE
  To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling.
  
  
  METHODS
  Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis.
  
  
  RESULTS
  No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50-74% blanching, 20% achieved 25-49% blanching, and 30% achieved less than 25% blanching.
  
  
  CONCLUSIONS
  In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous.
authors.affiliation: Department of Surgery, Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
authors.forename: Vandana S
authors.initials: VS
authors.lastname: Nanda
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019339:Port-Wine Stain / Q000532:radiotherapy*