Effective laser correction of multiple teleangiectasia on the face

Abstract

Telangiectasia is a persistent dilation of small-caliber skin vessels (arterioles, venules, capillaries) of a non-inflammatory nature, manifested by polymorphously convoluted and dilated vessels. Telangiectasias are classified according to the cause of occurrence, the form of changes in the vascular pattern, time and localization, and are also divided into 3 large groups ― essential (idiopathic); symptomatic in various diseases; congenital and hereditary syndromes and diseases accompanied by vascular anomalies. In addition, telangiectasias can be single and multiple, located locally or disseminated, differ in shape, location, color; sometimes they bleed. Differential diagnosis is carried out with flaming and telangiectatic nevus; multiple senile, glomerular, bundle angiomas; Fabry angiokeratoma, Sivatts poikiloderma. In addition, telangiectasia is a typical clinical symptom in the erythematous-telangiectatic form of rosacea, systemic scleroderma, discoid lupus erythematosus, nodular form of basal cell carcinoma, hyper- and atrophic scars, late radiation dermatitis.
 The article describes a case from the clinical practice of effective treatment of telangiectasias on the skin of the face using a neodymium crystal laser, which is of interest, among other things, due to the complexity of diagnosis within the existing International Classification of Diseases 10 revision, therefore the diagnosis is made syndromally based on macro- and microscopic morphological features. In addition, there is no single approach to the treatment of the pathology in question. External therapy, as well as systemic drugs, are often ineffective, sclerotherapy and exposure to a high-power vascular laser have a more pronounced clinical effect (broadband light; neodymium laser; pulsed dye laser; alexandrite, diode, ruby laser). Based on the recommendations of the laser manufacturer on percutaneous vascular coagulation and modern theories about the pathogenesis of telangiectasias, an algorithm for treatment with a long-pulse laser with a wavelength of 1064 nm on a clinical example is proposed. By prescribing a course of treatment of vascular malformation by laser percutaneous coagulation, we expect to obtain the destruction of pathologically dilated vessels of the papillary and mesh layer of the dermis by gluing the walls of the vessels (preferably) or complete thrombosis of their lumen while maintaining the structures of the dermis and epidermis intact. Laser percutaneous vascular coagulation has demonstrated excellent treatment results in a short period of time, significantly reducing the number of pathologically altered vessels. The rehabilitation period after laser coagulation of blood vessels did not exceed 3 days and was manifested by moderate edema of soft tissues in the area of laser exposure, hyperemia and single petechial hemorrhages, which resolved themselves.
 Laser coagulation of skin telangiectsies is a highly effective method with a long-term clinical effect.