[Treatment of hemangiomas in infancy and childhood with the flash lamp-pumped dye laser: cutaneous versus mixed cutaneous-subcutaneous hemangiomas].

The efficacy of flashlamp-pumped pulsed dye laser therapy at 585 nm for cutaneous and mixed hemangiomas was assessed in 165 children with 225 separate hemangiomas were treated in 332 sittings over 2.5 years. The patients were divided into three groups: 100 patients with 153 flat cutaneous hemangiomas, 47 patients with 54 mixed cutaneous-subcutaneous hemangiomas and 18 patients with 18 superficial hemangiomas in the involution phase. In the first group of 100 patients with 153 flat cutaneous hemangiomas, 52 (34%) of the lesions showed total lightening. 21 of the 153 lesions showed proliferation of the subcutaneous component, although these lesions were flat at first presentation. Of the 54 mixed hemangiomas, 33 (61%) had continued proliferation of the subcutaneous component. The cutaneous component responded to therapy in 21 (39%) hemangiomas while the subcutaneous component of the mixed hemangiomas remained unchanged. No lesions in this group involuted completely and therapy was discontinued because of a relatively poor response to therapy. 12 (67%) of the 18 patients with superficial hemangiomas in the involution phase had excellent results, and 6 (33%) had good results. We conclude that treatment with the flashlamp-pumped pulsed dye laser is very effective and may be the treatment of choice for selected hemangiomas, especially cutaneous hemangiomas at sites of potential functional impairment (hands or feet, anogenital-region), and on the face. Furthermore, laser therapy should be initiated as early as possible, even in the first days or weeks of life, when the hemangioma is flat, to prevent enlargement, promote involution, or eliminate these vascular lesions.