title: Treatment of sporadic port-wine stains: a retrospective review of 17 cases consecutively treated by pulsed sequential dual wavelength 595 and 1064 nm laser.
abstract: BACKGROUND
  Port-wine stains (PWS) are relatively common and often cause cosmetic and psychological concerns. The pulsed dye laser is currently the treatment of choice for PWS.
  
  
  OBJECTIVE
  To assess the effectiveness of the pulsed sequential dual wavelength 595 and 1064 nm laser as first-line treatment for PWS and to identify prognostic factors for treatment outcome in a retrospective series of 17 consecutive previously untreated patients.
  
  
  METHODS
  The response to treatment was evaluated 2 months after treatment utilizing comparative photographs and a standard physician global assessment (PGA) grading system. Furthermore, measurement of the normalized erythema index (NEI) reduction (ΔNEI%) was carried out using an image analysis system. The subjective improvement was assessed using a patient's satisfaction questionnaire. Multiple linear regression models were finally used to identify factors associated with ΔNEI% and patients' satisfaction.
  
  
  RESULTS
  Seventeen patients, with PWS, including 12 children were included. The average PGA assessment was 2.5 ± 1.3 corresponding to an amelioration of 50% with a high intraclass correlation coefficient among the experts. The before-after NEI showed a statistically significant mean reduction of 3.5 ± 2.6 units, corresponding to a relative reduction of 31%. Questionnaires showed that the satisfaction was very good with an average score of 6.1 points on a scale ranging from -10 to 10 points. Multiple regression analysis revealed that location in the frontotemporal area was associated with a significant reduction in ΔNEI% (38.4%; 95% CI 4.3, 72.6). Presence of PWS on the neck was associated with a lower patient satisfaction (-3.7 points; 95% CI -6.5, -0.9). There were no significant side-effects, except for transient discomfort and purpura.
  
  
  CONCLUSIONS
  Based on the results obtained in the largest reported series so far, the pulsed sequential dual wavelength 595 and 1064 nm laser represents an effective and safe first-line therapeutic option for the treatment of PWS.
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: D L
authors.initials: DL
authors.lastname: Perruchoud
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.|Centro Studi GISED, Bergamo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cazzaniga
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Heidemeyer
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Weber
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Dietrich
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Borradori
authors.affiliation: Department of Dermatology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.
authors.forename: M A
authors.initials: MA
authors.lastname: Adatto
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005546:Forehead; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D054025:Lasers, Dye / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009333:Neck; D017060:Patient Satisfaction; D019339:Port-Wine Stain / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult