INITIAL LESION SIZE AS A PREDICTIVE FACTOR IN DETERMINING THE RESPONSE OF PORT-WINE STAINS IN CHILDREN TREATED WITH THE PULSED DYE-LASER

Objective: To evaluate the response of facial port-wine stains in children to pulsed (450 microseconds) dye (577- or 585-nm) laser treatment based on the age of the patient and the size of the port-wine stain at the initiation of treatments. Design: Case series. Setting: Outpatient dermatology clinic at the University of Colorado School of Medicine, Denver. Patients: A consecutive sample of 83 children who had facial port-wine stains that were treated in their entirety at each visit. Intervention: Patients were treated with a pulsed (450 microseconds) dye (577- and 585-nm) laser. Main Outcome Measure: Decrease in size of the port-wine stain. Results: Overall 18 (22%) of the 85 patients responded with complete clearing of their port-wine stains. The port-wine stains in 32% (7/22) of the patients who began treatment before 1 year of age responded with complete clearing of their port-wine stains compared with 18% (11/61) in older patients ;(P<.01). Fifteen (32%) of 47 patients with port-wine stains smaller than 20 cm(2) at initial evaluation were totally cleared vs three (8%) of the 36 patients with port-wine stains larger than 20 cm(2) (P<.05). This size effect is apparent at all ages. Conclusion: When considering treatment for facial port-wine stains with pulsed dye lasers, it is important to consider not only the age of the child at the beginning of treatments, but also the initial size of the lesion.