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Early-onset hypertrophic port-wine stains had poor response to laser treatment

Port-wine stains with early-onset hypertrophy were associated with complications and had a low response to laser treatment, according to published study results.

Researchers conducted a retrospective study of 98 patients with facial port-wine stains (PWS) and underlying hypertrophy that developed before the age of 18 years. The mean age of patients was 20 years at the time of consultation, with a female-male ratio of 1.67. Factors recorded included age of onset of the hypertrophy, location, association with odontologic problems, presence of other associated complications and laser treatment response.

In 77 patients, the mean age at onset of hypertrophy was 5.6 years. Twenty patients (26%) had congenital hypertrophy, with all segments of the face involved. In 39.8% of cases, odontologic problems were observed. Orthodontic treatment performed in some patients and results were better when it was performed early. For severe cases, stomatologic surgery was proposed.

Cataracts, asymmetric development of maxillary bone, and speech delay and disorders were other complications reported in 18.4% of the patients.

There were 67 patients who received laser treatment, with pulsed dye laser used in all but five patients. Patients started laser treatment at a mean age of 9 years, with a mean of 14 laser, and mean total duration of laser treatments of 8 years.

Complete or nearly complete clearance of port-wine stains was achieved by 3% of patients, with 67.2% of patients reporting below 50% improvement and 1.5% of patients experiencing worsening of port-wine stains after laser sessions.

In patients with early-onset hypertrophic port-wine stains, “response to laser treatment … appears less favorable than is reported for [port-wine stains] in general,” the researchers wrote. “In classic [port-wine stains], 50% to 90% clearance is reported with approximately 10% improvement per treatment session.”

 “Periodic monitoring is recommended for early detection and treatment of complications,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.