title: Long-pulsed 1064 nm Nd:YAG laser improves hypertrophic port-wine stains.
abstract: BACKGROUND
  Hypertrophic port-wine stains (PWS) usually respond poorly to pulsed dye laser treatment. The long-pulsed 1064 nm Nd:YAG laser can target deeper situated vessels and may therefore be more effective.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of the Nd:YAG laser for the treatment of hypertrophic PWS.
  
  
  METHODS
  In a retrospective cohort study, all hypertrophic PWS patients treated with the Nd:YAG laser between 2005 and 2011 were invited for follow-up. Clinical improvement was assessed using Physician Global Assessment (PhGA) and Patient Global Assessment (PGA).
  
  
  RESULTS
  Assessment was obtained in 32 of 44 eligible patients (mean age 51.4 years), after a mean of 2.8 (SD ± 2.1) Nd:YAG laser treatments. Good or excellent improvement of hypertrophy was found in a majority of patients, both by PhGA (91%) and PGA (93%). Good or excellent improvement of colour was found in 63% of patients by PhGA, and in 87% by PGA. Recurrence of hypertrophy was seen in three patients. All but two patients would recommend Nd:YAG treatment to other patients. Mild to moderate scars were seen in seven patients, hypopigmentation in 14 patients.
  
  
  CONCLUSIONS
  The 1064 nm Nd:YAG laser is highly effective in the treatment of hypertrophic PWS with only a few treatments needed. Mostly mild side effects were seen in half of all patients. Hypertrophy seems to respond better than colour. To further improve colour, a combination with pulsed dye laser treatment is advisory. Observation of immediate clinical endpoints is important when using the Nd:YAG laser, to optimize outcomes and reduce side effects.
authors.affiliation: Netherlands Institute for Pigment Disorders (SNIP), Academic Medical Center, University of AmsterdamDepartment of Dermatology, Academic Medical Center, University of AmsterdamThe Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital (NKI-AVL), Amsterdam, The Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: van Drooge
authors.forename: B
authors.initials: B
authors.lastname: Bosveld
authors.forename: J P W
authors.initials: JP
authors.lastname: van der Veen
authors.forename: M A
authors.initials: MA
authors.lastname: de Rie
authors.forename: A
authors.initials: A
authors.lastname: Wolkerstorfer
mesh_terms: D006801:Humans; D053685:Laser Therapy; D054025:Lasers, Dye; D008875:Middle Aged; D019339:Port-Wine Stain / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome