title: Carbon dioxide laser for the treatment of microcystic lymphatic malformations (lymphangioma circumscriptum): a systematic review.
abstract: BACKGROUND
  Lymphangioma circumscriptum (LC) is a rare, superficial, cutaneous lymphatic malformation. Management is difficult because of high recurrence rates, regardless of the treatment modality chosen. The carbon dioxide (CO2 ) laser may offer a less-invasive option than surgery that provides satisfactory functional and cosmetic results.
  
  
  OBJECTIVE
  To systematically review the efficacy and safety of the CO2 laser for the treatment of LC.
  
  
  METHODS
  The terms "lymphangioma circumscriptum" and "microcystic lymphatic malformation" were combined with "treatment," "laser," and "carbon dioxide" during separate searches in the PubMed database. The articles retrieved were then evaluated based on set criteria.
  
  
  RESULTS
  We identified 16 studies (11 case reports, 5 case series) with a total of 28 separate patients who had been treated for LC using a CO2 laser. Eight patients remained disease free from 4 months to 3 years, 10 experienced partial recurrence, and two experienced complete recurrence. Various laser parameters were reported, and adverse effects were generally minor and infrequent, such as dyspigmentation and mild scarring.
  
  
  CONCLUSIONS
  Available evidence indicates that the CO2 laser is a safe and efficacious option for the treatment of LC, particularly in large lesions that may not be amenable to surgical intervention.
authors.affiliation: Department of Dermatology & Cutaneous Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA. jsavas@med.miami.edu
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Savas
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ledon
authors.forename: Katlein
authors.initials: K
authors.lastname: Franca
authors.forename: Anna
authors.initials: A
authors.lastname: Chacon
authors.forename: Martin
authors.initials: M
authors.lastname: Zaiac
authors.forename: Keyvan
authors.initials: K
authors.lastname: Nouri
mesh_terms: D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D044148:Lymphatic Abnormalities / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012871:Skin Diseases / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome