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Previous Volume 338:1028-1033 April 9, 1998 Number 15 Next

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ABSTRACT

Background Port-wine stains can be treated with a flash-lamp–pumped pulsed-dye laser, but it is uncertain whether this treatment is more effective if administered early in life, when the skin is thinner and the lesion is smaller.

Methods We prospectively studied 100 patients with a previously untreated port-wine stain of the head or neck. They were treated with the flash-lamp–pumped pulsed-dye laser and divided into four age groups (0 to 5, 6 to 11, 12 to 17, and 18 to 31 years). The outcome measure was lightening of the port-wine stain (reduction in the difference in color between the skin with the stain and contralateral healthy skin) as measured with a colorimeter after an average of five treatments (range, three to seven) of the entire lesion.

Results Of the 100 patients, 11 could not be included in the analysis because they had received fewer than three or more than seven treatments, had an erroneous base-line color measurement, or were lost to follow-up. The sizes, locations, and colors of the port-wine stains were similar among the groups. When all 89 patients were analyzed together, the average reduction in the difference in color between the skin with the port-wine stain and contralateral healthy skin was 40 percent. The differences between age groups in the average reduction in color differences were not significant (P = 0.26). By the end of the study, only 7 of 89 patients had completed laser therapy, and in no case was clearance complete. Treatment was discontinued in all seven because the last three treatments did not lead to further lightening.

Conclusions We found no evidence that treatment of port-wine stains with the flash-lamp–pumped pulsed-dye laser in early childhood is more effective than treatment at a later age.

Source Information

From the Department of Plastic Reconstructive and Hand Surgery (C.M.A.M.H., P.H.L.K.), the Department of Clinical Epidemiology and Biostatistics (C.A.J.M.B., P.M.M.B.), and the Laser Center (M.J.C.G.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Address reprint requests to Dr. van der Horst at the Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.

Full Text of this Article

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