This article is more than 5 years old. Information may no longer be current.

Long-pulsed Nd:YAG laser treats nonport-wine stains in children

Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for children with nonport-wine stain vascular malformations was effective and well-tolerated, according to recently published study results in the Journal of the American Academy of Dermatology.

Researchers in the dermatology department, University of California, San Francisco, conducted a retrospective study of 29 pediatric patients (mean age, 9.3 years; 66% female) with nonport-wine stains who were treated with long-pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG) laser between 2009 and 2014.

Patient demographics, prior treatments, treatment details, clinical responses and complications were recorded.

The patients included 17 with venous malformations, five with glomuvenous malformations, one with multifocal lymphangioendotheliomatosis and one with targetoid hemosiderotic hemangioma. Most of the malformations were located on the head and neck (48%) and extremities (31%).

Eighteen patients had prior interventions, including pulsed dye laser, sclerotherapy and/or excision. There was a mean of 4.6 Nd:YAG laser treatments.

A panel of four experts, including two pediatric laser surgeons, one adult dermatology laser surgeon and one general pediatric dermatologist, who were blinded to laser parameters and number of treatments, used pretreatment and posttreatment photographs to rate clinical improvement.

The panel rated good-to-excellent results in 66.7% of patents and poor-to-fair results in 25% of patients.

Minor blistering and skin breakdown were the most common adverse events. The overall adverse event rate was 27%.

“Overall, treatment with the [long-pulsed] Nd:YAG laser was found to be well tolerated and beneficial for controlling symptomatic or disfiguring non-[port-wine stain] low-flow vascular malformations in children,” the researchers wrote. “[Venous malformations] of the head and the neck, particularly those involving the oral mucosa, tended to respond the best.

“The decision to proceed with laser surgery is shared with the child (if age appropriate) and the family, with emphasis on control, not cure. Considerations include the risks of laser treatment (thermal burns, ulceration and scarring), the nature of the malformation (potential for worsening after treatment, persistence or recurrence) and the risk associated with repeated general anesthesia.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.