"Hot" KTP-laser treatment of facial angiofibromata

Background and Objective: Treatment of facial angiofibromata (AF) relied la rgely upon cutaneous resurfacing. While effective, resurfacing affects larg e areas with attendant risks of dyspigmentation, infection, and scarring. W e investigated the pulsed KTP (532 nm) laser energy for its high absorption by melanin and hemoglobin as a photothermal destructive method for treatin g AF. Study Design/Materials and Methods: In five patients (Fitzpatrick phototype s II-VI), AF were treated with the KTP laser (10 ms, 20 J/cm(2), 2 mm beam) using stacked pulses (2-3.3 Hz) or passes. No cooling device was employed. Each pulse evoked puffs of steam and caused progressive flattening of AF. Normal intervening skin was strictly avoided. Patients underwent one to fiv e sessions in which as many as 100 lesions were treated. Results: Individual lesions responded with complete flattening in one or tw o treatments. While this effect has persisted for 18-24 months, slow recrud escence is expected. Transient hypopigmentation and hyperpigmentation were localized to treated skin. No scarring, infection, or other adverse events were observed. Patient satisfaction with this method was high due to rapid healing time (< 10 days), minimal pain, ease of wound care, and efficacy. Conclusions: "Hot" KTP laser is an effective and safe method of treatment f or facial AF. Limiting treatment only to lesional skin allowed rapid healin g and very limited adverse effects despite the increased non-specific therm al damage caused by high fluence, long pulse duration, and an absence of su perficial tissue cooling. (C) 2001 Wiley-Liss, Inc.