ADVERSE REACTIONS FOLLOWING PULSED TUNABLE DYE-LASER TREATMENT OF PORT-WINE STAINS IN 701 PATIENTS

The pulsed tunable dye laser (PTDL) is generally considered to have a very low incidence of adverse effects, allowing it to become the treat ment of choice for the majority of port wine stains (PWS). The low inc idence of adverse effects has led to difficulties in determining the t rue incidence and type of adverse effect seen with this laser, We ther efore undertook a retrospective study of 701 patients with PWS, who re ceived 3877 full treatments to determine the incidence and type of adv erse effects seen following treatment with the PTDL. Blistering and cr usting were seen in 5.9% and 0.7% of patients. respectively, but were transient events which usually healed without permanent sequelae. Hype rpigmentation was the most frequently observed adverse effect seen in 9.1% of patients but generally showed gradual resolution over 6-12 mon ths, Hypopigmentation was infrequent, seen in 1.4% of patients. The mo st significant adverse effects were atrophic and hypertrophic scarring seen in 4.3% and 0.7% of patients, respectively, Our observations sho w that there is a small but definite risk of atrophic scarring with a predisposition for younger patients. Hypertrophic scarring can occur a lbeit rarely and there may be a predisposition towards the neck. In mo st cases test areas were not predictive of scarring, This underlines t he need for a full discussion of scarring risk in patients with PWS un dergoing treatment with the PTDL.