Treatment of Nodules Associated With Port Wine Stains With CO2 Laser: Case Series and Review of the Literature
February 2009 | Volume 8 | Issue 2 | Case Report | 157 | Copyright © 2009
Emily P. Tierney MD, C. William Hanke MD MPH
Background: Port wine stains (PWS) are congenital malformations of capillaries, where with progression, blood vessels become
ectatic and result in disﬁguring nodules.
Objective: To search the MEDLINE database and review literature on the treatment of PWS and present 2 cases of adults with PWS, complicated by hypertrophic and nodular lesions, treated successfully with CO 2 laser.
Results: Two patients with PWS, with nodular and hypertrophic areas, were treated with CO 2 laser. With the ﬁrst patient, improve- ment of 90% or greater was noted in the 14 discrete nodules present within the PWS in a V2 distribution. At baseline, ectropion of the lower eyelid was noted which resolved completely after CO 2 laser. With the second patient, improvement was noted as 90% or greater in the 40 of 51 discrete nodules present within the PWS extending across the right V1-V2 distribution.
Conclusion: Carbon dioxide ablative laser resurfacing is safe and highly effective in the treatment of the nodular and hypertrophic components of PWS. Future treatment of PWS will likely involve a hybrid approach of utilizing nonablative lasers of varying wave- lengths and pulse durations and treatment with novel laser devices, with the goal of early treatment to prevent progression of PWS to disﬁguring lesions.
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