Successful Treatment of Cutaneous Collagenous Vasculopathy with Pulsed Dye Laser: A Case Report

Abstract

Cutaneous collagenous vasculopathy (CCV) is clinically characterized by symmetrical, progressive telangiectasias and an absence of systemic involvement. Histopathology is distinct and helps in differentiation from other vascular conditions that result in cutaneous telangiectasias. We present a case of biopsy-proven CCV that had localized clearance following biopsy and was successfully treated with pulsed dye laser. A healthy 36-year-old male presented with a 10-year history of progressive, blanching telangiectasias of the legs, thighs, and forearms. A punch biopsy of a representative patch on the patient’s right thigh demonstrated telangiectasias with thickened PAS-positive vessel walls and a sparse perivascular lymphoid infiltrate, features consistent with a diagnosis of CCV. While there was localized clearance at the biopsy site and adjacent skin, the patient opted for treatment with PDL for his lesions elsewhere. After testing various PDL settings, greatest cosmetic improvement and minimal PIH was achieved with a spot size of 7 mm, pulse duration of 3 milliseconds (ms) and a fluence of 8 J/cm2. Continued resolution of CCV was noted at 24 months. We present this case to underscore the potential efficacy of PDL in the treatment of CCV.