Yoon-Soo Cindy Bae1, Hamad Alabdulrazzaq2, Jeremy A Brauer3, Roy G Geronemus3. 1. Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York; Laser and Skin Surgery Center of New York, New York, New York. Electronic address: yoonsoobae@yahoo.com. 2. Laser and Skin Surgery Center of New York, New York, New York. 3. Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York; Laser and Skin Surgery Center of New York, New York, New York.
Abstract
BACKGROUND: Pulsed dye laser (PDL) is the treatment of choice for port-wine stains (PWS). Some PWS are recalcitrant to this modality. A number of reasons for PDL treatment resistance have been described, including inadequate heat generation. OBJECTIVE: We evaluated PDL combined with radiofrequency (RF) energy into a single device to target larger and deeper blood vessels and overcome PDL resistance. METHOD: This was an open-label, prospective, single-center investigation of a novel device combining RF energy with PDL conducted to treat recalcitrant PWS. Ten patients with 11 recalcitrant PWS were enrolled. Each PWS was divided into 5 treatment areas: PDL alone, RF alone, PDL+RF, RF+PDL, and untreated control. Patients underwent a maximum of 6 treatments, scheduled 4 to 6 weeks apart with follow-up evaluation at 4 and 12 weeks after the final treatment. Colorimetry and standardized digital photography were performed at all visits. Lesional biopsy specimens were collected for selected patients. RESULTS: Areas treated with RF followed by PDL and PDL followed by RF showed the greatest improvement based on blinded review of digital photographs, reaching statistical significance (P value < .05) at the 12-week follow-up evaluation when compared with baseline. Adverse events, including purpura, erythema, edema, scabbing, crusting, and blistering, resolved without sequelae; a small residual scar was noted in 1 patient. LIMITATIONS: Small sample size and short follow-up period are limitations. CONCLUSION: Combined RF/PDL technology is promising for the treatment of recalcitrant PWS.
BACKGROUND: Pulsed dye laser (PDL) is the treatment of choice for port-wine stains (PWS). Some PWS are recalcitrant to this modality. A number of reasons for PDL treatment resistance have been described, including inadequate heat generation. OBJECTIVE: We evaluated PDL combined with radiofrequency (RF) energy into a single device to target larger and deeper blood vessels and overcome PDL resistance. METHOD: This was an open-label, prospective, single-center investigation of a novel device combining RF energy with PDL conducted to treat recalcitrant PWS. Ten patients with 11 recalcitrant PWS were enrolled. Each PWS was divided into 5 treatment areas: PDL alone, RF alone, PDL+RF, RF+PDL, and untreated control. Patients underwent a maximum of 6 treatments, scheduled 4 to 6 weeks apart with follow-up evaluation at 4 and 12 weeks after the final treatment. Colorimetry and standardized digital photography were performed at all visits. Lesional biopsy specimens were collected for selected patients. RESULTS: Areas treated with RF followed by PDL and PDL followed by RF showed the greatest improvement based on blinded review of digital photographs, reaching statistical significance (P value < .05) at the 12-week follow-up evaluation when compared with baseline. Adverse events, including purpura, erythema, edema, scabbing, crusting, and blistering, resolved without sequelae; a small residual scar was noted in 1 patient. LIMITATIONS: Small sample size and short follow-up period are limitations. CONCLUSION: Combined RF/PDL technology is promising for the treatment of recalcitrant PWS.
Authors: M Ingmar van Raath; Sandeep Chohan; Albert Wolkerstorfer; Chantal M A M van der Horst; Jacqueline Limpens; Xuan Huang; Baoyue Ding; Gert Storm; René R W J van der Hulst; Michal Heger Journal: PLoS One Date: 2020-07-02 Impact factor: 3.240
Authors: Sara Sabeti; Karen L Ball; Craig Burkhart; Lawrence Eichenfield; Esteban Fernandez Faith; Ilona J Frieden; Roy Geronemus; Deepti Gupta; Andrew C Krakowski; Moise L Levy; Denise Metry; J Stuart Nelson; Megha M Tollefson; Kristen M Kelly Journal: JAMA Dermatol Date: 2021-01-01 Impact factor: 10.282