title: Combined pulsed dye laser and fiberoptic Nd-YAG laser for the treatment of hypertrophic port wine stain.
abstract: The hypertrophic Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. We used combined PDL and fiberoptic 1444-nm Nd-YAG laser to treat a case with hypertrophic PWS.
  
  
  METHODS
  After tumescent anesthesia, few holes were made by a 16-gauge needle on different sides of the lesion. The fiberoptic tip of 1444-nm Nd-YAG laser was inserted within the holes and was pushed forward while triggering. In a fan pattern and by a back and forth movement, the subcutaneous and deep dermal areas were coagulated. The skin and outer mucosal surfaces were then treated by PDL. The fiberoptic system used was Accusculpt 1444-nm Nd-YAG laser (Lutronic lasers, South Korea), and the PDL used was 585 nm Nlite system (Chromogenex UK). The parameters used for PDL were fluence = 9 Joules/cm2and the spot size was 5 mm. The parameters used for fiberoptic 1444-nm Nd-YAG laser were: Pulse rate = 30 Hz, pulse energy = 300 mJ, power = 6 W, and the total energy = 4000 J for the whole face and mucosa.
  
  
  RESULTS
  Little sign of regression and moderate purpura were detected immediately after combined fiberoptic Nd-YAG and PDL therapy. The lesion gradually regressed within 4 months with satisfactory color and volume change.
  
  
  CONCLUSIONS
  Combined fiberoptic Nd-YAG laser and PDL can be used for the treatment of deeper and superficial layers of hypertrophic PWS.
authors.affiliation: a Department of Dermatology , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Radmanesh
authors.affiliation: b Medical School, Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Radmanesh
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques; D005260:Female; D006801:Humans; D007493:Iraq; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D019339:Port-Wine Stain / Q000532:radiotherapy*
keywords: Fiberoptic Nd-YAG laser; port wine stain; pulsed dye laser