Pulsed dye laser treatment of port-wine stains in pigmented skin

Background: Little information is available on pulsed dye laser treatment o f darker Fitzpatrick skin types. Methods: We retrospectively reviewed our clinical experience treating mainl y facial (12/13) port-wine stains (PWSs) in 13 patients of skin type V, who se ages ranged from 3 to 65 years. Results: The response was excellent in 2 patients, good or moderate in 4 ea ch, slight in 1, and poor in 2. Hyperpigmentation occurred in 6 patients an d hypopigmentation in 1, which improved despite continuing treatment. Limit ed atrophic scarring developed in two patients. Although these results were less good and side effects more frequent than described in skin types I to IV: 6 patients (46%) achieved a good or excellent response and 85(87.6%) o f the total 97 laser treatments were not associated with significant proble ms. Conclusion: Patients of skin type V with a PWS should not be excluded from pulsed dye laser therapy provided that treatment expectations and risks are fully discussed.