B.C. Swan, S. Robertson, E. Ma, A. Tuxen, L. Bingham, L. Ly, B. Welsh, V. Morgan, P. Bekhor
Introduction: Capillary malformations (CM) affect 0.3%
newborns and have a psychosocial impact. Pulsed dye laser (PDL) treatment at 6–12 weekly intervals under general
anaesthetic (GA) in early life remains the treatment of
choice. The safety of repeated GA in infants is controversial,
but prior to 3–6 months old, PDL treatment can be performed
without GA. Shortening the PDL treatment interval
can reduce the course duration to 3 months or less, and has,
in adults, been shown to be more effective. We investigated
the effectiveness and safety of PDL treatment in infants at 2
weekly intervals (without GA) compared to three monthly.
Method: We performed a prospective pilot study of 9
infants less than 8 weeks old with CM. Using 595 nm Vbeam
PDL, the entire CM was treated, then half of the CM was
randomly allocated to 2 weekly and other half to 3 monthly
intervals for further 2 treatments. Three month posttreatment
photographs were evaluated by an independent,
blinded dermatologist. Complications were recorded.
Results: Three patients had greater improvement on the 2
weekly treated side compared to 4 patients with greater
improvement on the 3 monthly treated side including 3 with
excellent results. Two patients showed equal improvement
on both sides. There were no significant adverse reactions.
Conclusion: This pilot study suggests that infants may be
treated with PDL without GA at 2 weekly intervals without
adverse effects. While preliminary data would suggest a
better outcome with 3 monthly intervals, further larger
studies are warranted for statistical significance. Two
weekly PDL intervals for treatment of CM in infants needs
consideration as this shortens treatment duration and minimises
GA.