Treatment of sporadic port-wine stains: a retrospective review of 17 cases consecutively treated by pulsed sequential dual wavelength 595 and 1064 nm laser.

BACKGROUND: Port-wine stains (PWS) are relatively common and often cause cosmetic and psychological concerns. The pulsed dye laser is currently the treatment of choice for PWS. OBJECTIVE: To assess the effectiveness of the pulsed sequential dual wavelength 595 and 1064 nm laser as first-line treatment for PWS and to identify prognostic factors for treatment outcome in a retrospective series of 17 consecutive previously untreated patients. METHODS: The response to treatment was evaluated 2 months after treatment utilizing comparative photographs and a standard physician global assessment (PGA) grading system. Furthermore, measurement of the normalized erythema index (NEI) reduction (ΔNEI%) was carried out using an image analysis system. The subjective improvement was assessed using a patient's satisfaction questionnaire. Multiple linear regression models were finally used to identify factors associated with ΔNEI% and patients' satisfaction. RESULTS: Seventeen patients, with PWS, including 12 children were included. The average PGA assessment was 2.5 ± 1.3 corresponding to an amelioration of 50% with a high intraclass correlation coefficient among the experts. The before-after NEI showed a statistically significant mean reduction of 3.5 ± 2.6 units, corresponding to a relative reduction of 31%. Questionnaires showed that the satisfaction was very good with an average score of 6.1 points on a scale ranging from -10 to 10 points. Multiple regression analysis revealed that location in the frontotemporal area was associated with a significant reduction in ΔNEI% (38.4%; 95% CI 4.3, 72.6). Presence of PWS on the neck was associated with a lower patient satisfaction (-3.7 points; 95% CI -6.5, -0.9). There were no significant side-effects, except for transient discomfort and purpura. CONCLUSIONS: Based on the results obtained in the largest reported series so far, the pulsed sequential dual wavelength 595 and 1064 nm laser represents an effective and safe first-line therapeutic option for the treatment of PWS.

Photorejuvenation of the forearms by treating hyperpigmented lesions with intense pulsed light source: a case report.

UNLABELLED: A 55 year old Spanish patient, photo type III, wanted a cosmetic improvement of her forearms. She disliked the hyperpigmentation which made her look older. METHOD: After having tried several chemical peelings (50% glycolic acid plus 10% kojic acid followed by 15% MM TCA), there was no improvement in the patients's condition and it was decided to initiate intense pulsed light (IPL) treatment. RESULTS: Improvement was noted after the first session, with a slight pink coloration. At two months post treatment, we noted more than 90% clearance of the hyperpigmentation on the treated areas. CONCLUSION: This case report confirms that photorejuvenation, by treating hyperpigmented lesions with intense pulsed light source on extra-facial zones can be very effective and safe.

Striae treated by a novel combination treatment--sand abrasion and a patent mixture containing 15% trichloracetic acid followed by 6-24 hrs of a patent cream under plastic occlusion.

BACKGROUND: Striae are a common cosmetic problem, especially for women. Little has been published about chemical peel treatment of striae. OBJECTIVE: To recount 5 years experience of striae treated by a novel combination treatment--sand abrasion and a patent mixture containing 15% trichloracetic acid followed by 6-24 h of a patent cream under plastic occlusion. MATERIALS AND METHODS: Sixty-nine females of various phototypes, aged 14-63 years, were treated at various anatomical sites: abdomen (43), lateral thighs (11), breasts (4), back (3), waist (3) and others (5). Striae of all types: fresh, old, mild and severe, were treated. Average follow up was 18 months. RESULTS: After 1-8 treatments (median 4.2), appearance of the striae improved by 70%. Results were best in fresher and more superficial striae. CONCLUSIONS: A novel combination treatment is reported which safely, predictably and effectively improved striae in all skin types.