Comparison of a combination diode laser and radiofrequency device (Polaris) and a long-pulsed 1064-nm Nd:YAG laser (Lyra) on leg telangiectases. Histologic and immunohistochemical analysis.
BACKGROUND
Several devices have been proposed for the treatment of leg telangiectases. For most of these devices the histologic changes induced in the dermis are not well characterized.


METHODS
Three volunteers with class I-II red and blue 0.1-2.0 mm leg telangiectases were treated with the Lyra (Laserscope, San Jose, CA, USA) and the Polaris (Syneron Medical Ltd, Yokneam, Israel) devices to the left and right legs, respectively. Two 3-mm punches were taken from either site 7 days after treatment. The specimens were routinely processed and also stained for elastic tissue and collagen tissue.


RESULTS
After treatment, specimens treated with both the Polaris and the Lyra showed intermediate-sized vessels with complete thrombosis and extensive hemorrhage in both the dermis and subcutis. The overlying epidermis also evidenced damage characterized as focal full-thickness necrosis. Special stains confirmed the damage to the vessels. All other skin structures were morphologically unremarkable. An average of 50-75% clinical clearing occurred using both modalities of a single treatment session.


CONCLUSIONS
Our study confirms that both devices result in severe damage to small, intermediate-sized vessels, thus explaining the reported clinical improvement of leg telangiectases. The expression of hsp70 in the dermal vessels and overlying epidermis is consistent with a direct thermal effect delivered by either device.
Department of Pathology, UT-MD Anderson Cancer Center, Houston, TX, USA.
Victor
V
Prieto
Peter
P
Zhang
Neil S
NS
Sadick
D006801:Humans; D007150:Immunohistochemistry; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods*; D054023:Lasers, Semiconductor; D007866:Leg / Q000098:blood supply*; D000078702:Radiofrequency Therapy; D013194:Staining and Labeling; D013684:Telangiectasis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome