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An Assessment of 5 Years of Treatment

Steven S. Orten, MD; Milton Waner, MD, FCS(SA); Stephen Flock, PhD; Paula K. Roberson, PhD; Jay Kincannon, MD

Arch Otolaryngol Head Neck Surg. 1996;122(11):1174-1179.

Abstract
Objective
To assess objectively the results of flashlamp-pumped dye laser treatment of port-wine stains (PWS).

Design
Pretreatment and posttreatment photographs were compared with the appearance of the lesion at follow-up examination. Clinical response was determined by assigning a percentage of lesional lightening score by 2 physicians and the patient, and by reflectance spectrophotometric measurements.

Setting
University and university-affiliated health center.

Patients
One hundred two patients (118 PWS) aged 1 month to 66 years (mean, 20 years; median, 16 years) treated from July 1, 1989, to June 30, 1994.

Results
Eighteen (15.3%) of the 118 PWS had more than 90% lesional lightening (complete or almost complete response), 77 (65.3%) had lightening from 50% to 90% (good response), 21 (17.8%) had lightening from 11% to 49% (poor response), and 2 (1.7%) had lightening less than 10% (no response). Clinical response did not vary among age groups, but showed statistically significant differences between anatomical locations. A return of PWS after initial response was observed in patients who were seen more than 1 year following completion of treatment.

Conclusions
Treatment of PWS by flashlamp-pumped dye laser results in a good to complete response in most patients. Anatomical location of the lesion is a valuable prognostic indicator of response to treatment. The initially impressive results of flashlamp-pumped dye laser treatment of PWS may be tempered by the gradual return of the vascular lesion as time elapses after completion of therapy. Our experience indicates that PWS show a tendency to recur at a rate approaching 50% between 3 and 4 years after completion of treatment.

Arch Otolaryngol Head Neck Surg. 1996;122:1174-1179

Author Affiliations
From the Departments of Otolaryngology–Head and Neck Surgery (Drs Orten, Waner, Flock, and Roberson) and Dermatology (Dr Kincannon), University of Arkansas for Medical Sciences, Little Rock.

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