Lasers in Medical Science

, Volume 28, Issue 4, pp 1197–1204 | Cite as

Lasers for cutaneous congenital vascular lesions: a comprehensive overview and update

  • Katlein França
  • Anna Chacon
  • Jennifer Ledon
  • Jessica Savas
  • Jan Izakovic
  • Keyvan Nouri
Review Article

Abstract

The use of laser to treat cutaneous lesions began with Dr. Leon Goldman and his coworkers in 1963. Ten years later, these authors described promising effects on angiomas using the continuous-wave neodymium:yttrium–aluminum–garnet laser. In 1983, Anderson et al. proposed the photothermolysis theory. The selective destruction of vascular lesions is based on this principle, and it is still a guide for treatment of vascular lesions. Over the past 25 years, laser treatment of cutaneous vascular lesions has progressed significantly. Vascular lasers such as argon, tunable dye, krypton, and copper vapor were used in the past and were associated not only with risk of scarring but also hyper- and hypopigmentation. Since then, new devices were developed in order to minimize these side effects. This article presents an overview and update of the current available treatment of cutaneous vascular lesions and covers future directions for vascular laser technology.

Keywords

Lasers Cutaneous congenital vascular lesions Cutaneous vascular lesions 

References

  1. 1.
    Cole PD, Sonabend ML, Levy ML (2007) Laser treatment of pediatric vascular lesions. Semin Plast Surg 21(3):159–166PubMedCrossRefGoogle Scholar
  2. 2.
    Bogdan Allemann I, Goldberg DJ (eds) (2011) Basics in dermatological laser applications. Curr Probl Dermatol. Basel, Karger 42: 1–6Google Scholar
  3. 3.
    Keyvan Nouri. Laser treatment of acquired and congenital vascular lesions. Available: http://emedicine.medscape.com/article/1120509-overview
  4. 4.
    Srinivas CR, Kumaresan M (2011) Lasers for vascular lesions: standard guidelines of care. Indian J Dermatol Venereol Leprol 77(3):349–368PubMedCrossRefGoogle Scholar
  5. 5.
    Natalie K. Selective photothermolysis. Available: http://plasticsurgery.about.com/od/glossary/g/selective_PTL.htm. Accessed 09 Aug 2012
  6. 6.
    Michael D, Kilmer S (2012) Lasers for treatment of vascular lesions. In: Lasers in dermatology and medicine. Springer 33–44Google Scholar
  7. 7.
    Adamic M, Troilius A, Adatto M, Drosner M, Dahmane R (2007) Vascular lasers and IPLS: guidelines for care from the European Society for Laser Dermatology (ESLD). J Cosmet Laser Ther 9(2):113–124PubMedCrossRefGoogle Scholar
  8. 8.
    Jurgensen GF, Hedelund L, Hζdersdal M (2008) Long-pulsed dye laser versus intense pulsed light for photodamaged skin: a randomized split-face trial with blinded response evaluation. Lasers Surg Med 40:293–299CrossRefGoogle Scholar
  9. 9.
    Rothfleisch JE, Kosmann MK, Levine VJ, Ashinoff R (2002) Laser treatment of congenital and acquired vascular lesions: update on lasers: a review. Dermatol Clin 20:1–18PubMedGoogle Scholar
  10. 10.
    Wall T (2007) Current concepts: laser treatment of adult vascular lesions. Semin Plast Surg 21(3):147–158PubMedCrossRefGoogle Scholar
  11. 11.
    Huang LP, Luo JL, Chen J, Zhang CH, Chen L (2011) Laser treatment of port wine stains. Zhonghua Zheng Xing Wai Ke Za Zhi 27(5):348–351PubMedGoogle Scholar
  12. 12.
    Renfro L, Geronemus RG (1993) Anatomical differences of port-wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 129:182–188PubMedCrossRefGoogle Scholar
  13. 13.
    Keyvan Nouri. Laser treatment of acquired and congenital lesions. Available: http://emedicine.medscape.com/article/1120509-overview#showall. Accessed 10 Aug 2012
  14. 14.
    Schneider BV, Mitsuhashi Y, Schnyder UW (1988) Ultrastructural observations in port wine stains. Arch Dermatol Res 280:338–345PubMedCrossRefGoogle Scholar
  15. 15.
    Barsky SH, Rosen S, Geer DE, Noe JM (1980) The nature and evolution of port wine stains: a computer-assisted study. J Investig Dermatol 74:154–157PubMedCrossRefGoogle Scholar
  16. 16.
    Lanigan SW, Cotterill JA (1989) Psychological disabilities amongst patients with port wine stains. Br J Dermatol 121:209–215PubMedCrossRefGoogle Scholar
  17. 17.
    Malm M, Carlberg M (1988) Port-wine stain—a surgical and psychological problem. Ann Plast Surg 20:512–516PubMedCrossRefGoogle Scholar
  18. 18.
    Peters MA, van Drooge AM, Wolkerstorfer AG et al (2012) Double pass 595 nm pulsed dye laser at a 6 minute interval for the treatment of port-wine stains is not more effective than single pass. Lasers Surg Med 44(3):199–204PubMedCrossRefGoogle Scholar
  19. 19.
    Geronemus RG, Ashinoff R (1991) The medical necessity of evaluation and treatment of port-wine stains. J Dermatol Surg Oncol 17:76–79PubMedCrossRefGoogle Scholar
  20. 20.
    Faurschou A, Olesen AB, Leonardi-Bee J, Haedersdal M (2011) Lasers or light sources for treating port-wine stains. Cochrane Database Syst Rev 9(11):CD007152Google Scholar
  21. 21.
    Kelly KM, Nanda VS, Nelson JS (2002) Treatment of port-wine stain birthmarks using the 1.5-msec pulsed dye laser at high fluences in conjunction with cryogen spray cooling. Dermatol Surg 28:309–313PubMedCrossRefGoogle Scholar
  22. 22.
    Tunnell JW, Chang DW, Johnston C, Torres JH, Patrick CW Jr, Miller MJ et al (2003) Effects of cryogen spray cooling and high radiant exposures on selective vascular injury during laser irradiation of human skin. Arch Dermatol 139:743–750PubMedCrossRefGoogle Scholar
  23. 23.
    Dai T, Pikkula BM, Tunnell JW, Chang DW, Anvari B (2003) Thermal response of human skin epidermis to 595-nm laser irradiation at high incident dosages and long pulse durations in conjunction with cryogen spray cooling: an ex-vivo study. Lasers Surg Med 33:16–24PubMedCrossRefGoogle Scholar
  24. 24.
    Izikson L, Nelson JS, Anderson RR (2009) Treatment of hypertrophic and resistant port wine stains with a 755 nm laser: a case series of 20 patients. Lasers Surg Med 41(6):427–432PubMedCrossRefGoogle Scholar
  25. 25.
    Liu S, Yang C, Yang S, Wang Z, Luo D, Zhang X (2012) Topical application of 5-aminolevulinic acid followed by 595 nm pulse dye laser irradiation for the treatment of recalcitrant port-wine stains—a primary study. J Cosmet Laser TherGoogle Scholar
  26. 26.
    Dantow J, Mintz D, Ogrady MJ (1986) Treatment of port wine stains with the CO2 laser. J Otolaryngol 15(1):35–38PubMedGoogle Scholar
  27. 27.
    Tierney EP, Hanke CW (2009) Treatment of nodules associated with port wine stains with CO2 laser: case series and review of the literature. J Drugs Dermatol 8(2):157–161PubMedGoogle Scholar
  28. 28.
    Patel AM, Chou EL, Findeiss L, Kelly KM (2012) The horizon for treating cutaneous vascular lesions. Semin Cutan Med Surg 31(2):98–104PubMedCrossRefGoogle Scholar
  29. 29.
    Qiu H, Gu Y, Wang Y et al (2011) Twenty years of clinical experience with a new modality of vascular-targeted photodynamic therapy for port wine stains. Dermatol Surg 37:1603–1610PubMedCrossRefGoogle Scholar
  30. 30.
    Burns AJ, Navarro JA (2009) Role of laser therapy in pediatric patients. Plast Reconstr Surg Issue 124(1 Supplement):82e–92eCrossRefGoogle Scholar
  31. 31.
    Bernstein EF (2009) The pulsed-dye laser for treatment of cutaneous conditions. G Ital Dermatol Venereol 144(5):557–572PubMedGoogle Scholar
  32. 32.
    Siegfried EC, Keenan WJ, Al-Jureidini S (2008) More on propranolol for hemangiomas of infancy. N Engl J Med 359(26):2846, author reply 2846–7PubMedCrossRefGoogle Scholar
  33. 33.
    Saint-Jean M, Léauté-Labrèze C, Mazereeuw-Hautier J et al (2011) Propranolol for treatment of ulcerated infantile hemangiomas. J Am Acad Dermatol 64(5):827–832PubMedCrossRefGoogle Scholar
  34. 34.
    Moehrle M, Léauté-Labrèze C, Schmidt V, Röcken M, Poets CF, Goelz R (2012) Topical timolol for small hemangiomas of infancy. Pediatr DermatolGoogle Scholar
  35. 35.
    Amir J, Metzker A, Krikler R, Reisner SH (1986) Strawberry hemangioma in preterm infants. Pediatr Dermatol 3(4):331–332PubMedCrossRefGoogle Scholar
  36. 36.
    Batta K, Goodyear HM, Moss C, Williams HC, Hiller L, Waters R (2002) Randomised controlled study of early pulsed dye laser treatment of uncomplicated childhood haemangiomas: results of a 1-year analysis. Lancet 360:521–527PubMedCrossRefGoogle Scholar
  37. 37.
    David LR, Malek MM, Argenta LC (2003) Efficacy of pulse dye laser therapy for the treatment of ulcerated haemangiomas: a review of 78 patients. Br J Plast Surg 56:317–327PubMedCrossRefGoogle Scholar
  38. 38.
    Liu A, Moy RL, Ross EV, Hamzavi I, Ozog DM (2012) Pulsed dye laser and pulsed dye laser-mediated photodynamic therapy in the treatment of dermatologic disorders. Dermatol Surg 38(3):351–366PubMedCrossRefGoogle Scholar
  39. 39.
    Ashinoff R, Geronemus RG (1991) Capillary hemangiomas and treatment with the flashlamp-pumped pulsed dye laser. Arch Dermatol 127:202–205PubMedCrossRefGoogle Scholar
  40. 40.
    Garden JM, Bakus AD, Paller AS (1992) Treatment of cutaneous hemangiomas by the flashlamp-pumped pulsed dye laser: prospective analysis. J Pediatr 120:555–560PubMedCrossRefGoogle Scholar
  41. 41.
    Poetke M, Philipp C, Berlien HP (2000) Flashlamp-pumped pulsed dye laser for hemangiomas in infancy: treatment of superficial vs mixed hemangiomas. Arch Dermatol 136(5):628–632PubMedCrossRefGoogle Scholar
  42. 42.
    Civas E, Koc E, Aksoy B, Aksoy HM (2009) Clinical experience in the treatment of different vascular lesions using a neodymium-doped yttrium aluminum garnet laser. Dermatol Surg 35(12):1933–1941PubMedCrossRefGoogle Scholar
  43. 43.
    Vlachakis I, Gardikis S, Michailoudi E et al (2003) Treatment of hemangiomas in children using a Nd:YAG laser in conjunction with ice cooling of the epidermis: techniques and results. BMC Pediatr 3:2PubMedCrossRefGoogle Scholar
  44. 44.
    Saafan AM, Salah MM (2010) Using pulsed dual-wavelength 595 and 1064 nm is more effective in the management of hemangiomas. J Drugs Dermatol 9(4):310–314PubMedGoogle Scholar
  45. 45.
    Li DN, Gold MH, Sun ZS, Tang AR, Wang HB, Sheng-Kang L (2010) Treatment of infantile hemangioma with optimal pulse technology. J Cosmet Laser Ther 12(3):145–150PubMedCrossRefGoogle Scholar
  46. 46.
    Caucanas M, Paquet P, Henry F, Piérard-Franchimont C, Reginster M-A, Piérard GE (2011) Intense pulsed-light therapy for proliferative haemangiomas of infancy. Case Rep Dermatol Med 2011(253607):5. doi:10.1155/2011/253607 Google Scholar
  47. 47.
    Burns AJ, Navarro JA (2009) Role of laser therapy in pediatric patients. Plastic and Reconstructive Surgery 124(1 Supplement):82e–92ePubMedCrossRefGoogle Scholar
  48. 48.
    Gross RE (1953) Cystic hygroma. In: The surgery of infancy and childhood. Saunders, Philadelphia, pp 960–970Google Scholar
  49. 49.
    Patel GA, Siperstein RD, Ragi G, Schwartz RA (2009) Zosteriform lymphangioma circumscriptum. Acta Dermatovenerol Alp Panonica Adriat 18(4):179–182PubMedGoogle Scholar
  50. 50.
    Bond J, Basheer MH, Gordon D (2008) Lymphangioma circumscriptum: pitfalls and problems in definitive management. Dermatol Surg 34:271–275PubMedCrossRefGoogle Scholar
  51. 51.
    Heller M, Mengden S (2008) Lymphangioma circumscriptum. Dermatol Online J 14(5):27PubMedGoogle Scholar
  52. 52.
    Alpman A, Cogulu O, Akgul M, et al. (2008) Prenatally diagnosed Turner syndrome and cystic hygroma: incidence and reasons for referrals. Fetal Diagn Ther 25(1): 58–61. doi:10.1159/000199869. PMID 19202339Google Scholar
  53. 53.
    Arslan A, Gursoy H, Cologlu S (2011) Treatment of lymphangioma with CO2 laser in the mandibular alveolar mucosa. J Contemp Dent Pract 12(6):493–496PubMedCrossRefGoogle Scholar
  54. 54.
    Haas AF, Narurkar VA (1998) Recalcitrant breast lymphangioma circumscriptum treated by UltraPulse carbon dioxide laser. Dermatol Surg 24(8):893–895PubMedCrossRefGoogle Scholar
  55. 55.
    Bailin PL, Kantor GR, Wheeland RG (1986) Carbon dioxide laser vaporization of lymphangioma circumscriptum. J Am Acad Dermatol 14(2 Pt 1):257–262PubMedCrossRefGoogle Scholar
  56. 56.
    Smith HO, Genesen MC, Feddersen RM (1999) Dermal lymphangiomata of the vulva and laser therapy: a case report and literature review. Eur J Gynaecol Oncol 20:373–378Google Scholar
  57. 57.
    Egan CA, Rallis TM, Zone JJ (1998) Multiple scrotal lymphangiomas (lymphangiectasesa) treated by carbon dioxide laser ablation. Br J Dermatol 139:561–562PubMedCrossRefGoogle Scholar
  58. 58.
    Treharne L, Murison M (2006) CO2 laser ablation of lymphangioma circumscriptum of the scrotum. Lymphat Res Biol 4(2):101–103. doi:10.1089/lrb.2006.4.101 PubMedCrossRefGoogle Scholar
  59. 59.
    Lai CH, Hanson SG, Mallory SB (2001) Lymphangioma circumscriptum treated with pulsed dye laser. Pediatr Dermatol 18(6):509–510PubMedCrossRefGoogle Scholar
  60. 60.
    Cole PD, Sonabend ML, Levy ML (2007) Laser treatment of pediatric vascular lesions. Semin Plast Surg 21(3):159–166. doi:10.1055/s-2007-991184 PubMedCrossRefGoogle Scholar
  61. 61.
    Sivarajan V, Mackay IR (2005) Noninvasive in vivo assessment of vessel characteristics in capillary vascular malformations exposed to five pulsed dye laser treatments. Plast Reconstr Surg 115:1245–1252PubMedCrossRefGoogle Scholar
  62. 62.
    Telenkov SA, Dave DP, Sethuraman S, Akkin T, Milner TE (2004) Differential phase optical coherence probe for depth-resolved detection of photothermal response in tissue. Phys Med Biol 49:111–119PubMedCrossRefGoogle Scholar
  63. 63.
    Choi B, Majaron B, Nelson JS (2004) Computational model to evaluate port wine stain depth profiling using pulsed photothermal radiometry. J Biomed Opt 9:299–307PubMedCrossRefGoogle Scholar
  64. 64.
    Cuccia DJ, Bevilacqua F, Durkin AJ, Tromberg BJ (2005) Modulated imaging: quantitative analysis and tomography of turbid media in the spatial-frequency domain. Opt Lett 30:1354–1356PubMedCrossRefGoogle Scholar
  65. 65.
    Eubanks LE, McBurney EI (2001) Videomicroscopy of port-wine stains: correlation of location and depth of lesion. J Am Acad Dermatol 44:948–951PubMedCrossRefGoogle Scholar
  66. 66.
    Jung B, Choi B, Durkin AJ, Kelly KM, Nelson JS (2004) Characterization of port wine stain skin erythema and melanin content using cross-polarized diffuse reflectance imaging. Lasers Surg Med 34:174–181PubMedCrossRefGoogle Scholar
  67. 67.
    Choi B, Ramirez-San-Juan JC, Lotfi J, Stuart Nelson J (2006) Linear response range characterization and in vivo application of laser speckle imaging of blood flow dynamics. J Biomed Opt 11:041129PubMedCrossRefGoogle Scholar
  68. 68.
    Remlova E, Dostalová T, Michalusová I, Vránová J, Navrátil L, Rosina J (2011) Hemangioma curative effect of PDL, alexandrite, Er:YAG and CO(2) lasers. Photomed Laser Surg 29(12):815–825. doi:10.1089/pho.2011.3058, Epub 2011 Jul 27PubMedCrossRefGoogle Scholar
  69. 69.
    Greve B, Raulin C (2006) Laser therapy for vascular lesions. Hautarzt 57(6):537–548PubMedCrossRefGoogle Scholar
  70. 70.
    Chen JK, Ghasri P, Aguilar G, van Drooge AM, Wolkerstorfer A, Kelly KM, Heger M (2012) An overview of clinical and experimental treatment modalities for port wine stains. J Am Acad Dermatol 67(2):289–304PubMedCrossRefGoogle Scholar
  71. 71.
    Nguyen CM, Yohn JJ, Huff C, Weston WL, Morelli JG (1998) Facial port wine stains in childhood: prediction of the rate of improvement as a function of the age of the patient, size and location of the port wine stain and the number of treatments with the pulsed dye (585 nm) laser. Br J Dermatol 138:821–825PubMedCrossRefGoogle Scholar
  72. 72.
    Achauer BM, Vander Kam VM, Miller SR (1990) Clinical experience with the pulsed-dye laser in the treatment of capillary malformations (port-wine stains): a preliminary report. Ann Plast Surg 25:344–352PubMedCrossRefGoogle Scholar
  73. 73.
    Reyes BA, Geronemus R (1990) Treatment of port-wine stains during childhood with the flashlamp-pumped pulsed dye laser. J Am Acad Dermatol 23:1142–1148PubMedCrossRefGoogle Scholar
  74. 74.
    Izikson L, Nelson JS, Anderson RR (2009) Treatment of hypertrophic and resistant port wine stains with a 755 nm laser: a case series of 20 patients. Lasers Surg Med 41:427–432PubMedCrossRefGoogle Scholar
  75. 75.
    Izikson L, Anderson RR (2009) Treatment endpoints for resistant port wine stains with a 755 nm laser. J Cosmet Laser Ther 11:52–55PubMedCrossRefGoogle Scholar
  76. 76.
    Ho WS, Ying SY, Chan PC, Chan HH (2004) Treatment of port wine stains with intense pulsed light: a prospective study. Dermatol Surg 30:887–891PubMedCrossRefGoogle Scholar
  77. 77.
    Bjerring P, Christiansen K, Troilius A (2003) Intense pulsed light source for the treatment of dye laser resistant port-wine stains. J Cosmet Laser Ther 5:7–13PubMedGoogle Scholar
  78. 78.
    Reynolds N, Exley J, Hills S, Falder S, Duff C, Kenealy J (2005) The role of the Lumina intense pulsed light system in the treatment of port wine stains—a case controlled study. Br J Plast Surg 58:968–980PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  • Katlein França
    • 1
  • Anna Chacon
    • 1
  • Jennifer Ledon
    • 1
  • Jessica Savas
    • 1
  • Jan Izakovic
    • 1
  • Keyvan Nouri
    • 1
  1. 1.Department of Dermatology & Cutaneous SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

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