Comparing the effectiveness of 585-nm vs 595-nm wavelength pulsed dye laser treatment of port wine stains in conjunction with cryogen spray cooling.

Abstract

The objective of this study was to compare the efficacy and safety of cryogen spray cooled laser treatment (CSC-LT) at wavelengths of 585 nm vs. 595 nm for port wine stain (PWS) birthmarks in a large series of patients. A retrospective review was conducted of 64 patients with PWS treated with the ScleroPLUS [Candela (Wayland, MA)] pulsed dye laser (lambda = 585 or 595 nm wavelength; spot size 7 mm, tau(p) = 1,500 microseconds) 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 (n = 32) received CSC-LT (585 nm) using radiant exposures of 7-10 J/cm(2). A second group of patients (n = 32) received CSC-LT (595 nm) using radiant exposures of 7-10 J/cm(2). The primary efficacy measurement was the quantitative assessment of blanching response scores for CSC-LT (585 nm) versus CSC-LT (595 nm). Patients were monitored for adverse effects. Based on chi-squared analysis, there were clinical, and statistically significant, differences in blanching response scores favoring PWS receiving CSC-LT (585 nm) as compared to CSC-LT (595 nm) (P <.001). Transient hyperpigmentation was noted in 43.7% (n = 14) and 37.5% (n = 12) of patients in the CSC-LT (585 nm) and CSC-LT (595 nm) groups, respectively. In both groups, transient hyperpigmentation resolved in all patients within 1 year. Permanent hypopigmentation or scarring was not observed in either group. CSC-LT (585 nm) resulted in superior blanching as compared to CSC-LT (595 nm). Further study is required to optimize wavelength selection on an individual patient basis during PWS therapy in order to improve treatment results.