28423 Treatment of cutaneous lesions in patient with blue rubber bleb nevus with diode laser

Abstract

Blue rubber bleb nevus (BRBN) is a rare congenital skin disorder characterized by numerous, diffuse venous malformations of the cutaneous. The treatment of cutaneous lesions is not usually required except for cosmetic purposes while previous methods to remove cutaneous lesions including ND:YAG laser, photocoagulation, sclerotherapy, surgery often could lead to scars. We report a case of BRBN who had a good response to diode laser without adverse effects. A 16-month-old girl presented to our hospital with multiple, discrete, dark blue to violaceous soft compressible nodules on the skin as well as palm and sole. Especially, a large violaceous perianal lesion was about 4 cm in diameter that was at high risk for hemorrhage due to an anal fissure making the children occasionally bleeding while a bowel movement. Most of the lesions presented at birth remained stable in size and number. Abdominal ultrasound has not been discovered any abnormalities. Histopathology image of the cutaneous lesion shows variably sized, irregular and thin-walled vessels lined by a single layer of endothelial cells in the dermis. Immunohistochemical stain demonstrates endothelial cells positive for CD31. The girl has been treated using 810-nm diode laser at the setting 30-35 J/cm2, 30 ms for the cutaneous lesions on her back when the diagnosis of BRBN was established. After four times of treatment, a significant reduction in color and size was achieved on the back cutaneous lesions without adverse effects. In conclusion, this is the case of BRBN showing a good response to diode laser.