Port-wine-stain-associated dermatitis: implications for cutaneous vascular laser therapy.
Port-wine stains are congenital vascular malformations affecting 0.3% to 0.5% of infants. Dermatitis occurring exclusively or most severely within port-wine stains has been described in the literature. Traditionally, topical corticosteroid therapy has been used for the treatment of dermatitis, while pulseddye laser treatment is considered a safe and effective means of lightening the appearance of congenital port-wine stains. To describe the development of port-wine stain-associated dermatitis as well as a rational treatment approach to these patients, we studied three children with facial, limb, or truncal port-wine stains who developed dermatitis within the congenital vascular malformation either prior to or during treatment with pulseddye laser. Laser therapy of dermatitis-affected areas was subsequently deferred pending resolution of the dermatitis with topical corticosteroid or topical calcineurin inhibitor treatment. While pulseddye laser therapy is an effective means of lightening port-wine stains and achieving lasting resolution of any associated dermatitis, this therapy to dermatitis-affected areas should be postponed until the inflammation resolves to minimize the risk of laser-associated adverse effects.
Fonder
Margaret A
MA
Department of Dermatology, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Mamelak
Adam J
AJ
Kazin
Rebecca A
RA
Cohen
Bernard A
BA
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003872:Dermatitis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D028022:Low-Level Light Therapy; D019339:Port-Wine Stain / Q000150:complications* / Q000532:radiotherapy*
D000893:Anti-Inflammatory Agents