Treatment of cutaneous and mixed hemangiomas in infancy and childhood withthe flashlamp-pumped pulsed dye laser

The efficacy of flash lamp-pumped pulsed dye laser therapy at 585 nm for cu taneous and mixed hemangiomas was assessed in 165 children with 225 separat e hemangiomas were treated in 332 sittings over 2.5 years. The patients wer e divided into three groups: 100 patients with 153 flat cutaneous hemangiom as, 47 patients with 54 mixed cutaneous-subcutaneous hemangiomas and 18 pat ients with 18 superficial hemangiomas in the involution phase. In the first group of 100 patients with 153 flat cutaneous hemangiomas, 52 (34%) of the lesions showed total lightening. 21 of the 153 lesions showed proliferatio n of the subcutaneous component, although these lesions were flat at first presentation. Of the 54 mixed hemangiomas, 33 (61%) had continued prolifera tion of the subcutaneous component. The cutaneous component responded to th erapy in 21 (39%) hemangiomas while the subcutaneous component of the mixed hemangiomas remained unchanged. No lesions in this group involuted complet ely and therapy was discontinued because of a relatively poor response to t herapy. 12 (67%) of the 18 patients with superficial hemangiomas in the inv olution phase had excellent results, and 6 (33%) had good results. We concl ude that treatment with the flashlamp-pumped pulsed dye laser is very effec tive and may be the treatment of choice for selected hemangiomas, especiall y cutaneous hemangiomas at sites of potential functional impairment (hands or feet, anogenital-region), and on the face. Furthermore, laser therapy sh ould be initiated as early as possible, even in the first days or weeks of life, when the hemangioma is flat, to prevent enlargement, promote involuti on, or eliminate these vascular lesions.