title: Response of spider leg veins to pulsed diode laser (810 nm): a clinical, histological and remission spectroscopy study.
abstract: BACKGROUND
  Spider leg veins are common. Their treatment with laser or intensed light therapy shows generally variable success rates and often adverse side effects such as hyper- or hypopigmentation. This study was performed to investigate whether pulsed diode laser (810 nm) treatment is effective and safe.
  
  
  METHODS
  Thirty-five female patients with spider leg veins were included in this prospective trial. They were treated twice with a pulsed diode laser (810 nm; spot size 12 mm, frequency 2-4 Hz, pulse width 60 msec, fluence 80-100 Jcm(-2)). Laser therapy was performed on day 0 and day 14. Clinical assessments were carried out before and immediately after the first laser therapy, after 2 weeks, 8 weeks, and one year. Skin biopsies were taken before and immediately after the first laser treatment, and after 10 weeks. Contact-free remittance spectroscopy was performed before laser treatment, immediately after the first treatment, after 2 weeks and 8 weeks.
  
  
  RESULTS
  After the first treatment 15 patients showed a complete disappearance (CR) of spider leg veins; in the remaining 20 patients a remarkable improvement (RI) was noted (n=35). After six months of follow-up CR was seen in 6 patients, RI in 6, a stable situation in 9, and scar formation in 1 patient (n=21). The effect was almost completely stable during one year of follow-up. The examination of histological specimens before and after laser treatment showed no cellular inflammatory reaction. The mean vascular area was significantly reduced after the first (p<0.05) and after the second (p<0.05) laser treatment. Spectral analysis showed a marked decrease of peaks for oxygenized haemoglobin immediately after laser treatment and during the follow-up. Safety profile was excellent without purpuric reaction or pigmentary changes. Mild scarring was observed in two patients at the end of follow-up.
  
  
  CONCLUSIONS
  Pulsed diode laser therapy (810 nm) is an effective and safe treatment option for spider leg veins. The effects can be seen immediately. Objective monitoring by non-invasive remission spectroscopy and histology of biopsy specimens demonstrates selectivity of the laser action.
authors.affiliation: Department of Dermatology, Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany. Wollina-Uw@khdf.de
authors.forename: U
authors.initials: U
authors.lastname: Wollina
authors.forename: H
authors.initials: H
authors.lastname: Konrad
authors.forename: W-D
authors.initials: WD
authors.lastname: Schmidt
authors.forename: G
authors.initials: G
authors.lastname: Haroske
authors.forename: L G
authors.initials: LG
authors.lastname: Astafeva
authors.forename: D
authors.initials: D
authors.lastname: Fassler
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D013057:Spectrum Analysis; D013684:Telangiectasis / Q000473:pathology / Q000601:surgery*