Potassium titanyl-phosphate lasers may be treatment option in port wine birthmarks

Key takeaways:

• Pulsed dye lasers (PDL) are the current standard of care for port wine birthmarks.
• PDL has similar efficacy to potassium titanyl-phosphate (KTP) lasers, but pain was decreased with KTP lasers.

A potassium titanyl-phosphate laser has shown to have similar efficacy and less pain when compared with pulsed dye lasers in treating port wine birthmarks, according to a study.

“Port wine birthmarks are capillary malformations and are the most frequent vascular birthmarks affecting 0.3% to 0.5% of infants,” Lynhda Nguyen, MD, of the department of dermatology and venereology at University Medical Center Hamburg-Eppendorf in Germany, and colleagues wrote. “The current first-line therapy for PWB is pulsed dye laser (PDL)-mediated photothermolysis.”

This treatment operates at 585 nm or 595 nm and generally requires at least 10 treatments, the researchers continued, and although proven safe and effective, only 10% to 20% of patients report full clearance with PDL.

In a prospective, randomized, split-side trial, Nguyen and colleagues evaluated how a potassium titanyl-phosphate (KTP; DermaV, Lutronic Medical Systems) laser treatment regimen compared with PDL (VBeam Prima, Candela Medical Corporation) in treating port wine birthmarks.

The study included 35 adult patients with port wine birthmarks, with lesions divided into halves or quarters. Each section received either 532 nm KTP or 595 nm PDL for one to five treatments at 6- to 8-week intervals. There was a 6-week post-treatment follow-up.

Colorimetric analysis using delta E values, area reduction measurements and clinical evaluations of photos by blinded investigators were used to evaluate efficacy of both lasers. Safety and tolerability were measured by patient-reported edema, purpura, crusts and pain at every appointment.

Both systems showed significant effect in color and boundary and exhibited high patient satisfaction at the post-treatment assessment; however, there was no significant difference in these measurements between the two treatments, including in regard to lesion surface area reduction and colorimetric measurements.

However, pain intensity was significantly higher with PDL (3.8; 95% CI, –0.4 to 4.2) compared with KTP (2.7; 95% CI, –0.3 to 3.4).

“This study gives strong evidence for the effectiveness and safety of both the KTP laser and PDL in treating [port wine birthmark] patients,” the authors wrote. “Due to comparable efficacy, but lower downtime and more stable technology, the KTP laser may be even superior to conventional PDL treatment.”