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Port Wine Stains

■ Port Wine Stain Treatment with the Flash Lamp Pulsed Dye Laser

The flash lamp PDL was the first laser specifically designed for the selective photo thermolysis of cutaneous blood vessels. It is considered the best laser for the overall treatment of a mixed population of patients with port wine stains (PWS), although some individuals may benefit from other lasers. The laser's active medium is a rhodamine dye selected to produce yellow light at 577-595 nm. Most lasers emit the longer wavelength as this has been shown to have a deeper depth of penetration while also retaining vascular selectivity. The pulse duration is generally fixed at 450 ms. The main variables are the spot size and fluence. The spot sizes available with today's PDL are generally between 3 and 10 mm. Five- to ten-millimeter spot sizes are generally preferred as these will cover larger areas.

Table 2.4. Other disorders treated by vascular specific lasers

There are a number of studies reporting the efficacy of the PDL in the treatment of PWS (Figs. 2.5, 2.6). Results are generally reported in terms of lightening the PWS rather than the clearance, as complete clearance only occurs in the minority of patients. The vast majority of research papers use subjective criteria for improvement compared with baseline photo-

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