title: Fractional carbon dioxide laser ablation for the treatment of microcystic lymphatic malformations (lymphangioma circumscriptum) in an adult patient with Klippel-Trenaunay syndrome.
abstract: BACKGROUND
  Lymphangioma circumscriptum (LC) is a rare, benign, vascular malformation of dilated superficial lymphatic channels. Treatment is typically undertaken for cosmetic reasons or complications such as fluid drainage, pain, and infection risk that can negatively impact quality of life. Management of LC remains challenging because of high recurrence rates, regardless of the treatment modality chosen.
  
  
  OBJECTIVE
  Treatment of LC with the fully-ablative carbon dioxide (CO2) laser has been reported widely, however, treatment with the fractionated CO2laser has been limited to one case in the pediatric population. Our objective was to test the usefulness of the fractionated 10,600-nm CO2laser in the management of symptomatic LC in an adult.
  
  
  RESULTS
  We report a case of a 27-year-old female with Klippel-Trenaunay Syndrome (KTS) who presented with a 5-year history of well-circumscribed lesions on the right lateral and anterior thigh that drained clear lymphatic and serosanguineous fluid, respectively. These lesions caused her significant emotional distress because of extensive drainage. After only one treatment utilizing the fractionated 10,600-nm CO2laser, the patient had improvement with cessation of fluid drainage, and the lesions are still asymptomatic 6 months since initial treatment.
  
  
  CONCLUSIONS
  The favorable results observed in our patient suggest that fractionated CO2laser may be an additional well-tolerated, low downtime option for palliation of symptoms in patients with LC. We recognize that short-term follow-up cannot conclusively demonstrate effectiveness and durability of this treatment and that, given the high risk of recurrence, a longer-term observation is needed before making definite conclusions. Lasers Surg. Med. 47:539-541, 2015. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Saluja
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Marta
authors.initials: M
authors.lastname: Petersen
authors.affiliation: Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Erika
authors.initials: E
authors.lastname: Summers
keywords: ablative; fractional; laser; lymphangioma circumscriptum