Cheryl Chang

Background and Objectives: The objective of this study was to compare the efficacy and safety of cryogen spray cooled laser treatment at wavelengths of 585 nm vs. 595 nm for port wine stain birthmarks in a large series of patients. Study Design/Materials and Methods: A retrospective review was conducted of 64 patients with PWS treated with the ScleroPLUS® [Candela ] pulsed dye laser over a 3-year period. Subjects' ages ranged between 3 months and 64 years; there were 42 females and 22 males, all of whom were Asian. Number of treatments ranged from 1 to 6. Duration of treatment ranged from 6 months to 2 years 11 months, with a mean of 12 months. Patients received CSC-LT using radiant exposures of 7-10 J/cm2. A second group of patients received CSC-LT using radiant exposures of 7-10 J/cm2. The primary efficacy measurement was the quantitative assessment of blanching response scores for CSC-LT versus CSC-LT. Patients were monitored for adverse effects. Results: Based on chi-squared analysis, there were clinical, and statistically significant, differences in blanching response scores favoring PWS receiving CSC-LT as compared to CSC-LT. Transient hyperpigmentation was noted in 43.7% and 37.5% of patients in the CSC-LT and CSC-LT groups, respectively. In both groups, transient hyperpigmentation resolved in all patients within 1 year. Permanent hypopigmentation or scarring was not observed in either group. Conclusions: CSC-LT resulted in superior blanching as compared to CSC-LT. Further study is required to optimize wavelength selection on an individual patient basis during PWS therapy in order to improve treatment results. © 2002 Wiley-Liss, Inc.

When a cryogen spurt is applied to the skin surface for tens of milliseconds, cooling remains localized in the epidermis, leaving the temperature of deeper hemangioma vessels unchanged. The objective of this study was to compare the efficacy and safety of noncooled laser treatment vs. cryogen spray cooling plus laser treatment for cutaneous hemangiomas in a large series of patients. A retrospective review was conducted of 164 patients treated with the pulsed dye laser over an 8-year period. Eighty-two patients received NC-LT using light doses of 5.5 to 8 J per square centimeter. Subsequently, 82 patients received CSC-LT using light doses of 9 to 10 J per square centimeter. The primary efficacy measure was quantitative assessment of improvements in lesional volume, texture, and color. Safety was evaluated for each treatment group by monitoring for adverse effects. Based on chi-squared analysis, there were clinical and significant differences in the number of treatments, and improvement in volume and texture of the CSC-LT group compared with the NC-LT group. Permanent adverse effects were not observed in either group. In conclusion, CSC permitted the use of higher incident light doses for treatment of cutaneous hemangiomas, resulting in fewer treatments required and better improvement in lesional volume and texture.