Combined Laser Can Enhance Tx Of Hypertrophic Port Wine Stains

PALM DESERT, CALIF. — The one-two punch of a combination pulsed dye/Nd:YAG laser system can enhance the treatment of hypertrophic port wine stains, Dr. Elizabeth Tanzi said at the annual meeting of the American Society for Dermatologic Surgery.

Dr. Tanzi presented data on 25 patients with recalcitrant and hypertrophic port wine stains that she treated using the Cynergy laser workstation. All of the patients had at least 10 previous treatments that had not yielded a satisfactory result.

With the combined laser system, which was introduced in the United States last year by Cynosure Inc., all of the patients had "continued" improvement with four to six treatments, as judged by two independent reviewers 3 months after the last treatment, said Dr. Tanzi, a dermatologist in practice in Washington.

"This is a double whammy, so to speak. We really get a double hit on the vasculature," she said.

Pulsed dye laser treatment works well for many port wine stains, but not those that are thick and hypertrophic. The combination system appears to be better because treatment first with the pulsed dye laser heats hemoglobin and damages the vasculature but also creates a new chromophore susceptible to the Nd:YAG treatment that follows, she said.

One patient who had improvement with the Cynergy laser had received 16 previous treatments.

The Cynergy system allows the operator to fire both lasers through the same handpiece, so there is no need to change between treatments, which allows for quick firing between lasers, Dr. Tanzi said.

The patients were each treated at 6-month intervals. The spot size was 1 mm. The fluence used for the pulsed dye laser (595 nm) was 77.5 J with a pulse duration of 100 milliseconds; the fluence for the Nd:YAG laser was 30–50 J, with a pulse duration of 15 milliseconds. The delay between the two lasers' pulses was 0.5–1 millisecond.

Patients had some edema afterward that lasted for 1–4 days, but there was no vesicle formation, no dyspigmentation, and no scarring, she reported.

Dr. Tanzi said that the Cynergy workstation was provided to her clinic for the investigation by Cynosure.

PALM DESERT, CALIF. — The one-two punch of a combination pulsed dye/Nd:YAG laser system can enhance the treatment of hypertrophic port wine stains, Dr. Elizabeth Tanzi said at the annual meeting of the American Society for Dermatologic Surgery.

Dr. Tanzi presented data on 25 patients with recalcitrant and hypertrophic port wine stains that she treated using the Cynergy laser workstation. All of the patients had at least 10 previous treatments that had not yielded a satisfactory result.

With the combined laser system, which was introduced in the United States last year by Cynosure Inc., all of the patients had "continued" improvement with four to six treatments, as judged by two independent reviewers 3 months after the last treatment, said Dr. Tanzi, a dermatologist in practice in Washington.

"This is a double whammy, so to speak. We really get a double hit on the vasculature," she said.

Pulsed dye laser treatment works well for many port wine stains, but not those that are thick and hypertrophic. The combination system appears to be better because treatment first with the pulsed dye laser heats hemoglobin and damages the vasculature but also creates a new chromophore susceptible to the Nd:YAG treatment that follows, she said.

One patient who had improvement with the Cynergy laser had received 16 previous treatments.

The Cynergy system allows the operator to fire both lasers through the same handpiece, so there is no need to change between treatments, which allows for quick firing between lasers, Dr. Tanzi said.

The patients were each treated at 6-month intervals. The spot size was 1 mm. The fluence used for the pulsed dye laser (595 nm) was 77.5 J with a pulse duration of 100 milliseconds; the fluence for the Nd:YAG laser was 30–50 J, with a pulse duration of 15 milliseconds. The delay between the two lasers' pulses was 0.5–1 millisecond.

Patients had some edema afterward that lasted for 1–4 days, but there was no vesicle formation, no dyspigmentation, and no scarring, she reported.

Dr. Tanzi said that the Cynergy workstation was provided to her clinic for the investigation by Cynosure.

PALM DESERT, CALIF. — The one-two punch of a combination pulsed dye/Nd:YAG laser system can enhance the treatment of hypertrophic port wine stains, Dr. Elizabeth Tanzi said at the annual meeting of the American Society for Dermatologic Surgery.

Dr. Tanzi presented data on 25 patients with recalcitrant and hypertrophic port wine stains that she treated using the Cynergy laser workstation. All of the patients had at least 10 previous treatments that had not yielded a satisfactory result.

With the combined laser system, which was introduced in the United States last year by Cynosure Inc., all of the patients had "continued" improvement with four to six treatments, as judged by two independent reviewers 3 months after the last treatment, said Dr. Tanzi, a dermatologist in practice in Washington.

"This is a double whammy, so to speak. We really get a double hit on the vasculature," she said.

Pulsed dye laser treatment works well for many port wine stains, but not those that are thick and hypertrophic. The combination system appears to be better because treatment first with the pulsed dye laser heats hemoglobin and damages the vasculature but also creates a new chromophore susceptible to the Nd:YAG treatment that follows, she said.

One patient who had improvement with the Cynergy laser had received 16 previous treatments.

The Cynergy system allows the operator to fire both lasers through the same handpiece, so there is no need to change between treatments, which allows for quick firing between lasers, Dr. Tanzi said.

The patients were each treated at 6-month intervals. The spot size was 1 mm. The fluence used for the pulsed dye laser (595 nm) was 77.5 J with a pulse duration of 100 milliseconds; the fluence for the Nd:YAG laser was 30–50 J, with a pulse duration of 15 milliseconds. The delay between the two lasers' pulses was 0.5–1 millisecond.

Patients had some edema afterward that lasted for 1–4 days, but there was no vesicle formation, no dyspigmentation, and no scarring, she reported.

Dr. Tanzi said that the Cynergy workstation was provided to her clinic for the investigation by Cynosure.