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Triple pass laser therapy for recalcitrant facial port wine stains

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Abstract

Patients with recalcitrant facial port wine stains (rfPWS) can be challenging to manage, often leaving the clinician with difficult decisions for treatment options. ‘Triple therapy’ consists of using three different laser wavelengths at each treatment setting. The evidence on outcomes is limited as this treatment approach has not been previously reported to the best of our knowledge. Children who received triple therapy at least once for rfPWS, and for whom SIAscopy readings had been taken, were retrospectively identified. SIAscope readings were compared before the first triple therapy treatment and at final the most recent clinical follow-up. The clinical appearance was also assessed using a Visual Analogue Scale comparing clinical photographs taken before triple therapy to those taken at the most recent clinical follow-up. A total of 47 children were identified and included in our review. The SIAscope readings showed an overall significant (p < 0.001) lightening with 39 (83%) showing lightening and 8 (17%) patients showing a darkening. Scores using the VAS also showed improvement with 55% experiencing an improvement in their clinical appearance, 38% showing no visible change and 6% appearing to have worsened. Triple therapy can offer improvement of rfPWS which have failed to respond to single wavelength laser therapy. SIAscopy and VAS scores correlate well in assessing clinical response; however, the added clinical benefit of SIAscopy in vascular laser clinics remains uncertain.

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Acknowledgements

We would like to acknowledge the GOSH laser team, the patients and the parents for their contribution to this study.

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Authors and Affiliations

  1. Department of Medicine, Guy’s and St Thomas’ Hospital NHS Trust, Westminster Bridge Road, London, SE1 7EH, UK

    Giulia Rinaldi

  2. Gateshead Health NHS Trust, Gateshead, UK

    Adam Creissen

  3. Christchurch Hospital, Christchurch, Canterbury, New Zealand

    Caroline Mahon

  4. Great Ormond Street Hospital, London, UK

    Samira Batul Syed

Authors
  1. Giulia Rinaldi
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  2. Adam Creissen
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  3. Caroline Mahon
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  4. Samira Batul Syed
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Correspondence to Giulia Rinaldi.

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Informed written consent was obtained from all individual participants (and/or their guardians) whose pictures and clinical information were included in this study.

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The authors declare no competing interests.

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Rinaldi, G., Creissen, A., Mahon, C. et al. Triple pass laser therapy for recalcitrant facial port wine stains. Lasers Med Sci 37, 1643–1650 (2022). https://doi.org/10.1007/s10103-021-03414-x

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  • DOI: https://doi.org/10.1007/s10103-021-03414-x

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