Flash Pulse Dye Laser (595nm) Therapy on Facial Capillary Malformation

Laser eye protection was secured on the patient, surgeon and observers. A cheek, chin and lower lip capillary malformation was treated with 595-nm flash pulsed dye laser (PDL) on a pediatric patient for their yearly maintenance. The targeted area measured 25cm2. During the first pass the fluence was set at 9J/cm squared for a pulse duration of 1.5ms. The spray/delay cool setting was set to 40/20. The setting of the fluence and pulse duration were changed to 8.J/cm2 and 0.45ms respectively for a second pass allowing for complete coverage of the lesion. Assessment of the capillary malformation was assessed with digital photographs.

Flash pulse dye (PDL) at 585-595nm can be used as primary therapy for capillary malformations to prevent discoloration, growth and deformity.

Infections or inflammatory conditions of the affected skin. Avoid use the laser on areas of acute infections. Caution in dark (Fitzpatrick scale IV – VI) skin individuals as could lead to hypopigmentation.

N/A

Patient was sedated with general anesthesia in a sterile environment. Eye protection was given to all observers, patient, and surgeon.

In children with V1 facial distribution of the capillary malformation they should be evaluated for conditions associated with Sturge Weber Syndrome including an MRI of the brain to rule out meningeal involvement and Ophthalmology consult to rule out glaucoma. Full dermal examination should be performed for any other vascular lesions. Examine for associated hypertrophic conditions.

Caution and lower laser settings should be performed along vermilion border.

Blistering, hypopigemntation, and hyperpigementation. Midline facial capillary malformations can be resistant to laser therapy.

N/A

“Capillary Malformation: Boston Children's Hospital.” Boston Childrens Hospital, www.childrenshospital.org/conditions-and-treatments/conditions/c/capillary-malformation.
 
“Capillary Malformations.” Edited by Kiersten Ricci, Cincinnati Childrens, Feb. 2020, www.cincinnatichildrens.org/health/c/capillary. 

Cole, Patrick D, et al. “Laser Treatment of Pediatric Vascular Lesions.” Seminars in Plastic Surgery, Thieme Medical Publishers, 21 Aug. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2884839/. 

Rosenberg, Tara L., and Gresham T. Richter. “Lasers in the Treatment of Vascular Anomalies.” Current Otorhinolaryngology Reports, vol. 2, no. 4, 21 Sept. 2014, pp. 265–272., doi:10.1007/s40136-014-0065-6.