title: Clinical effects of dynamic cooling during pulsed laser treatment of port-wine stains.
abstract: Pulsed dye lasers permit effective treatment of port-wine stains without a significant risk of complications. However, epidermal damage manifested by weeping or crusting of the treated area have been reported in 48-83% of patients, and transient hyperpigmentation after treatment is observed in 10-57%. Theoretically, the epidermis can be protected from thermal damage with the use of the concept of selective epidermal cooling.This study examined the clinical effects of rapid cooling of the epidermis with a liquid refrigerant R-134a (boiling point - 26.5 double daggerC) during pulsed dye laser therapy. In 23 patients with port-wine stains, a 50-ms-long cooling pulse delivered immediately prior to laser irradiation with a fluence of 6.0 J cm(-2) significantly reduced the pain, and shortened the period with purpura without compromising the clinical blanching. Cooling periods longer than 60 ms, as well as additional cooling pulses immediately after laser exposure, reduced the blanching in areas irradiated with 6.0 J cm(-2).Post-treatment hyperpigmentation was not prevented with dynamic cooling.
authors.affiliation: Department of Dermatology, Norwegian University of Science and Technology, 7006, Trondheim, Norway.
authors.forename: E J
authors.initials: EJ
authors.lastname: Fiskerstran
authors.forename: K
authors.initials: K
authors.lastname: Ryggen
authors.forename: L T
authors.initials: LT
authors.lastname: Norvang
authors.forename: L O
authors.initials: LO
authors.lastname: Svaasand
references.citation: J Invest Dermatol. 1981 Sep;77(3):305-10
references.pmid: 7264364
references.citation: Arch Dermatol. 1993 Feb;129(2):182-8
references.pmid: 8434975
references.citation: Ann Plast Surg. 1994 May;32(5):478-84
references.pmid: 8060071
references.citation: Br J Dermatol. 1995 Sep;133(3):423-5
references.pmid: 8546998
references.citation: J Invest Dermatol. 1996 Nov;107(5):671-5
references.pmid: 8875947
references.citation: Br J Anaesth. 1989 Dec;63(6):655-60
references.pmid: 2532919
references.citation: Arch Dermatol. 1995 Jun;131(6):695-700
references.pmid: 7778922
references.citation: N Engl J Med. 1989 Feb 16;320(7):416-21
references.pmid: 2913507
references.citation: J Am Acad Dermatol. 1991 Mar;24(3):467-72
references.pmid: 2061448
references.citation: J Invest Dermatol. 1986 Nov;87(5):653-7
references.pmid: 3772159
references.citation: J Am Acad Dermatol. 1995 Apr;32(4):613-7
references.pmid: 7896952
references.citation: Br J Dermatol. 1996 Jun;134(6):1039-43
references.pmid: 8763421
references.citation: Arch Dermatol. 1986 Sep;122(9):1016-22
references.pmid: 3090945
references.citation: J Am Acad Dermatol. 1986 Jan;14(1):107-17
references.pmid: 3753989
references.citation: Phys Med Biol. 1982 Sep;27(9):1089-104
references.pmid: 6890212
references.citation: J Am Acad Dermatol. 1990 Dec;23(6 Pt 1):1142-8
references.pmid: 2273116
references.citation: Br J Dermatol. 1996 Mar;134(3):475-80
references.pmid: 8731672
references.citation: Pain. 1994 Feb;56(2):217-226
references.pmid: 8008411