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- Presentation
Treatment of Vascular Lesions
Description
The presentation covers the treatment of vascular lesions, particularly port wine birthmarks, emphasizing the importance of early intervention for better outcomes. The speaker advocates for treatment in newborns, asserting that doing so reduces the likelihood of hypertrophy, which affects a significant proportion of patients over time. Advances in laser technology, especially with the introduction of larger spot size lasers, have improved treatment efficiency and effectiveness while minimizing discomfort, allowing for effective treatments without general anesthesia. The speaker encourages treating patients with different skin types carefully by adjusting energy settings, particularly emphasizing the benefits of weekly treatments to avoid complications like purpura. Strategies for addressing various vascular lesions, including hemangiomas, are discussed, highlighting the synergistic effects of combining lasers with medications like Propranolol. Overall, the presentation showcases innovations in laser treatment, while underscoring the financial and comfort benefits of outpatient procedures for patients.
View moreConclusions
- Early intervention in the treatment of port wine stains significantly reduces the likelihood of hypertrophy in patients.
- Most patients with port wine stains will exhibit some degree of hypertrophy by age 45, emphasizing the need for early treatment.
- Using pulsed dye laser treatment (PDL) for infants can achieve substantial clearing, sometimes in a matter of months with weekly treatments.
- The new VBeam Pro laser technology improves treatment efficacy and patient comfort through faster sessions and enhanced post-treatment cooling.
- Engaging families in early treatment can minimize the risks associated with later intervention, such as general anesthesia.
- Treatments can begin as early as within a few days after birth, optimizing chances for better outcomes.
- In-office treatments without general anesthesia are well-tolerated and cost-effective compared to surgical options.
- Combination therapies that include both PDL and medication such as propranolol can lead to faster clearing rates for hemangiomas.
- Treatment strategies should consider skin types to minimize adverse effects, adapting energy levels as necessary.
- Regular assessments show that clear improvement correlates with early and consistent treatment, which is especially crucial for large or challenging birthmarks.
- Geronemus RG, Ashinoff R. The medical necessity of evaluation and treatment of port-wine stains. J Dermatol Surg Oncol. 1991;17(1):76-9.
- "PULSED DYE LASER TREATMENT OF PORT WINE STAINS IN INFANCY WITHOUT THE NEED FOR GENERAL ANESTHESIA: A RETROSPECTIVE ANALYSIS OF 197 PATIENTS" JAMA Dermatol. 2019; 155(4):435-441
- Hao Feng, Grace Materne, Sabrina Ghalili, Margo Lederhandler, Hyemin Pomerantz, Mitalee Christman, Leonard Bernstein, Roy G. Geronemus. ASSESSMENT OF TREATMENT TOLERANCE AND PARENTAL PERSPECTIVE OF OUTPATIENT PULSED DYE LASER TREATMENT FOR PORT WINE BIRTHMARK WITHOUT GENERAL ANESTHESIA IN INFANTS AND TODDLERS. J Am Acad Dermatol. 2020
- "Shouldn't Propranolol Be Used to Treat All Hemangiomas?" Aesthetic Plast. Surg. 2015 Dec;39(6):963-7 Moodley ST, Hudson DA, Adams S, Adams KG.
- "Topical Timolol Maleate Treatment of Infantile Hemangiomas." Pediatrics. 2016 Sep;138(3) Püttgen K, Lucky A, Adams D, Pope E, McCuaig C, Powell J, Feigenbaum D, Savva Y, Baselga E, Holland K, Drolet B, Siegel D, Morel KD, Garzon MC, Mathes E, Lauren C, Nopper A, Horii K, Newell B, Song W, Frieden I, Hemangioma Investigator Group
- "RETROSPECTIVE STUDY OF THE TREATMENT OF INFANTILE HEMANGIOMAS USING A COMBINATION OF PROPRANOLOL AND PULSED DYE LASER" LASER & SKIN SURGERY CENTER OF NEW YORK Dermatol Surg. 2013 Jun;39(6):923-33