Derm News: 2007.16(1)

Redarkening of Port-Wine Stains 10 Years after Pulsed-Dye-Laser Treatment

NEJM Volume 356:1235-1240 March 22, 2007 Number 12
Menno Huikeshoven, M.D., Ph.D., Petra H.L. Koster, M.D., Ph.D., Corianne A.J.M. de Borgie, M.D., Ph.D., Johan F. Beek, M.D., Ph.D., Martin J.C. van Gemert, Ph.D., and Chantal M.A.M. van der Horst, M.D., Ph.D.
ABSTRACT

Background

Although pulsed-dye-laser therapy is currently the gold standard for the treatment of port-wine stains, few objective data are available on its long-term efficacy. Using objective color measurements, we performed a 10-year follow-up of a previously conducted prospective clinical study of the treatment of port-wine stains with a pulsed-dye laser.

Methods

We invited the patients to undergo repeated color measurements performed by the same procedures as in the previous study. The results at long-term follow-up were compared with color measurements obtained before treatment and after completion of an average of five laser treatments of the complete port-wine stain. A questionnaire was used to investigate patients' satisfaction with the treatment and their perception of long-term changes in the stain.

Results

Of the 89 patients from whom color measurements were obtained in the previous study, 51 were included in this study. The patients had received a median of seven additional treatment sessions since the last color measurement, which had been made after an average of five treatments. The median length of follow-up was 9.5 years. On average, the stain when measured at follow-up was significantly darker than it was when measured after the last of the initial five laser treatments (P=0.001), but it was still significantly lighter than it was when measured before treatment (P<0.001). Fifty-nine percent of patients were satisfied with the overall treatment result. Six percent of patients reported that the stain had become lighter since their last treatment, 59% that it was unchanged, and 35% that it had become darker.

Conclusions

Using objective color measurements, we observed significant redarkening of port-wine stains at long-term follow-up after pulsed-dye-laser therapy. Patients should be informed about the possibility of redarkening before beginning treatment.

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