COPPER-VAPOR LASER (578 NM) AND FLASHLAMP-PUMPED PULSED TUNABLE DYE-LASER (585 NM) TREATMENT OF PORT-WINE STAINS - RESULTS OF A COMPARATIVE-STUDY USING TEST SITES

The copper vapour laser (CVL), emitting at 578 nm, has recently become available for treating vascular skin lesions. Its place in the manage ment of port wine stains (PWS) requires clarification. We have compare d a CVL with a pulsed tunable dye laser (PTDL; 585 nm) in 43 patients with macular, blanchable PWS. Test areas were performed with the CVL, using a Hexascan and an energy fluence just sufficient to produce imme diate tissue change (mean fluence 18.2 J/cm(2) and mean pulse width 50 ms). Test areas were performed with the PTDL using a 5-mm spot at 6.5 J/cm(2). Assessments were made after 4 months, subjectively using a c linical fading score and objectively using an index of light absorbenc e derived from reflectance spectrophotometry. The fading produced by t he PTDL was significantly better than the CVL, as determined by clinic al assessment (mean fading scores 2.41 and 1.67, respectively, P<0.000 5) and reflectance spectrophotometry (mean absorbence index 149 and 15 7 respectively, P<0.0005). These results indicate that the PTDL is the preferred treatment for most macular, blanchable PWS. However, in a p roportion of lesions responses were equivalent with both lasers, and i n a small proportion, the CVL produced a better response.