Improvement in the psychological impact of a port wine stain after successful pulsed dye laser therapy

BACKGROUND/AIMS: This study aims to measure and characterize the psychologi cal impact of a port wine stain on patients using a questionnaire and to me asure psychosocial changes after pulsed dye laser therapy. METHODS: Over a 5-year period, all 249 patients (192 females and 57 males) aged 15 years and older with a port wine stain (PWS) attending a laser clin ic completed a psychological questionnaire at their first visit. The overal l mean score (OMS) expressed as a percentage of the maximum possible score of 32 (%OMS) for all patients was 61.7%. RESULTS: The mean score was significantly higher for females (%OMS 63.8%; O MS 20.42, SD 7.9) than for males (%OMS 54.7%; OMS 17.5, SD 7.4; P<0.05). Pa tients with facial PWS (n = 208) had a %OMS of 59.4% (OMS 19.0, SD 7.8) whe reas those with PWS on the body (n =41) had a %OMS of 72.2% (OMS 23.1, SD 7 .1; P<0.05). There was no significant difference found in the OMS between d ifferent age groups, between flat or raised PWS or between different colour ed PWS. Of the 249 patients entered, 53 (21.3%) completed laser therapy and returned completed posttreatment questionnaires. For this cohort the %OMS prior to treatment was 61.2% (ORIS 19.6, SD 8.17) and fell to 35.2% (11.3, SD 10.05) after completing therapy (P<0.001). There was a clear link betwee n the magnitude of improvement in the ORIS and the successfulness of laser therapy. Patients cleared, or with excellent, good and fair outcomes follow ing laser treatment had reductions in %OMS of 64.5%, 62.5%, 37.5% and 16%, respectively. Only two patients had a poor outcome and had an OMS reduction of 43%. A significant decrease in response scores was seen for all eight s tatements following treatment. The greatest improvement was seen in respons e to questions on feelings of anxiety and embarrassment and the need to hid e the PWS. CONCLUSION: This study quantifiably demonstrates the benefits of successful pulsed dye laser therapy in reducing the psychosocial impact of a PWS.