title: Alexandrite Laser for the Treatment of Resistant and Hypertrophic Port Wine Stains: A Clinical, Histological and Histochemical Study.
abstract: BACKGROUND
  Port wine stains (PWSs) are commonly treated by the pulsed dye laser. However, treatment of hypertrophic or resistant PWSs is a major therapeutic challenge. The long-pulsed Alexandrite laser could be a safe and effective treatment for resistant PWSs, due to an increase depth of penetration of 50-75% over PDL.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy and safety of a long-pulsed Alexandrite laser in patients with hypertrophic, dark and/or resistant PWSs. Pink pale resistant PWS were excluded from the study.
  
  
  METHODS
  Twenty-one patients (age 20-75 years), phototypes I-IV on the Fitzpatrick scale, with PDL dark resistant PWSs were treated with long-pulsed Alexandrite laser. We excluded high phototypes and PDL pink resistant PWSs. All patients were treated with 3 laser sessions at settings of 3-ms pulse duration, 10-mm spot, 35-55J/cm(2), with cooling (Dynamic Cooling Device 50ms with delay 30ms). Laser sessions were repeated approximately every 2 months. Three dermatologists evaluated treatment effectiveness by means of photographs of the patients before and after laser treatment (scale from 0 to 4). Adverse events were registered. Patient satisfaction was also assessed (scale from 0 to 10).
  
  
  RESULTS
  Mean global improvement was rated as 2.28. Long-lasting side effects included minimal scarring after blistering in 1 patient. Mean patient satisfaction was 8.5.
  
  
  CONCLUSIONS
  Our study concludes that long-pulsed Alexandrite laser was effective for treatment of resistant PWSs, although the therapeutical window is narrow with this treatment.
authors.affiliation: Department of Dermatology, Ramón y Cajal University Hospital, Madrid, Spain. Electronic address: emiliano@doctoremilianogrillo.com.
authors.forename: E
authors.initials: E
authors.lastname: Grillo
authors.affiliation: Department of Dermatology, Guadalajara University Hospital, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: González-Muñoz
authors.affiliation: Department of Dermatology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Boixeda
authors.affiliation: Department of Pathology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Cuevas
authors.affiliation: Department of Dermatology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Vañó
authors.affiliation: Department of Dermatology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Jaén
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006984:Hypertrophy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019339:Port-Wine Stain / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alexandrite laser; Fluence; Fluencias; Histochemistry; Histoquímica; Láser de Alejandrita; Malformaciones capilares resistentes; Mancha en vino de Oporto; Port-wine stain; Resistant capillary malformations; Tratamiento; Treatment