Long-pulsed 1064-nm Nd:YAG laser in the treatment of infantile hemangioma: a 5-year retrospective analysis

Abstract

Objective To evaluate the clinical efficacy and characteristics of long-pulsed 1064-nm Nd:YAG laser in the treatment of infantile hemangioma. Methods Totally, 794 cases of infantile hemangioma (including 900 hemangioma lesions) treated with long-pulsed 1064-nm Nd:YAG laser in the First Hospital of Jilin University were included into this study. Clinical data were collected from these patients, including age, gender, age at onset of hemangioma, disease course, clinical types, lesional location and area, complications and treatment outcome. A retrospective analysis was carried out. The Mann- Whitney test was performed to compare therapeutic effects between male and female patients, and the Kruskal-Wallis H test to compare those among hemangioma at different sites and of different types. The central tendency and variability in patients' age and lesional area were expressed as median ± quartile range, and compared by the Kruskal-Wallis H test among hemangioma showing different therapeutic response. Factors influencing therapeutic response were analyzed by an ordinal multinomial logistic regression analysis. Results After 1-5 sessions of laser therapy, the total response rate was 87.56% (788/900) in the 794 patients with infantile hemangioma. There were significant differences in therapeutic response among patients of different ages (χ2= 103.131, P 0.05) or among hemangioma at different sites (χ2 = 2.34, P > 0.05). As the ordinal multinomial logistic regression analysis showed, the older the age, the better the therapeutic response (OR = 1.21, 95% CI: 1.14 - 1.28, P < 0.001). In addition, the therapeutic response was worse in subcutaneous hemangioma than in superficial hemangioma (OR = 0.30, 95% CI: 0.10 - 0.93, P = 0.037), and worst in mixed hemangioma (OR = 0.22, 95% CI: 0.17 - 0.29, P< 0.001). Adverse reactions included blisters, atrophic scars, hyperpigmentation, hypopigmentation and changes in skin texture, but no hyperplastic scars were observed. Conclusion Long-pulsed 1064-nm Nd:YAG laser is highly effective for the treatment of various kinds of infantilehemangioma in early stage with a good safety profile. Key words: Hemangioma; Lasers, solid-state; Treatment outcome; Age factors; Sex factors