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Variables affecting clinical response to treatment of facial port-wine stains by flash lamp-pumped pulsed dye laser: the importance of looking beyond the skin

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Abstract

The response of port-wine stains (PWS) to conventional laser treatment in adults is difficult to predict. To assess the influence of local or systemic hemodynamic variables on the clearance of PWS by using flash lamp-pumped pulsed (FLPP) dye laser. All consecutive patients ages 18 years or older undergoing laser treatment for a facial PWS were eligible. Laser sessions were scheduled every 8 weeks. All patients were evaluated based on a standard scale with four evaluation categories, from no or minimal improvement to total or almost total clearance. Clearance was achieved by 50.1 % (95 % confidence interval 35.6–64.7) of patients after a maximum of 15 treatment sessions. In multivariate analysis, increased age, a newly described Type III capillaroscopic pattern, and presence of lesions in dermatome V2 were all associated with a reduced clinical response to treatment. In a model restricted to demographic pattern and patient characteristics, arterial hypertension was also associated with a lower clinical response. A strong association was found between arterial hypertension and the Type III capillaroscopic pattern. Age, arterial hypertension, capillaroscopic pattern, and body location should be considered when planning laser treatment of PWS.

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Authors and Affiliations

  1. Istituto di Chirurgia e Laserchirurgia in Dermatologia (I.C.L.I.D.), Milano, Italy

    Pier Luca Bencini & Michela Gianna Galimberti

  2. Centro Studi GISED, Fondazione per la Ricerca Ospedale Maggiore, Bergamo, Italy

    Simone Cazzaniga & Luigi Naldi

  3. Clinica Dermatologica, Spedali Civili, Brescia, Italy

    Cristina Zane

  4. Italian High Tech Network in Dermatological Sciences, Milano, Italy

    Luigi Naldi

  5. Unità di Dermatologia, Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy

    Luigi Naldi

Authors
  1. Pier Luca Bencini
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  2. Simone Cazzaniga
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  3. Michela Gianna Galimberti
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  4. Cristina Zane
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  5. Luigi Naldi
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Correspondence to Luigi Naldi.

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Bencini, P.L., Cazzaniga, S., Galimberti, M.G. et al. Variables affecting clinical response to treatment of facial port-wine stains by flash lamp-pumped pulsed dye laser: the importance of looking beyond the skin. Lasers Med Sci 29, 1365–1370 (2014). https://doi.org/10.1007/s10103-014-1525-4

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  • DOI: https://doi.org/10.1007/s10103-014-1525-4

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