Department of Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan.
Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Japan.
Dermatol Surg. 2022 Aug 1;48(8):833-837. doi: 10.1097/DSS.0000000000003491. Epub 2022 May 17.
Infantile hemangioma (IH) often causes cosmetic disfigurement. Early intervention with propranolol for large, high-risk lesions is recommended in the American Academy of Pediatrics' Clinical Practice Guideline. Conversely, strategies for the management of small, low-risk lesions have not been established; however, pulsed dye laser (PDL) is often used to treat these lesions.
To investigate clinical outcomes of PDL in small IH lesions.
Fifty-three cases with 58 small IHs which did not meet the criteria for high-risk lesions in the guideline and were treated only with PDL were retrospectively reviewed. The characteristics of IHs and residual skin changes after treatment were evaluated.
Forty-seven lesions (81.0%) were superficial hemangiomas, whereas 11 (19.0%) were combined-type. The median maximum diameter was 10.0 mm. Forty-five lesions (77.6%) exhibited various residual skin changes after PDL treatment, including anetoderma (53.5%), telangiectasia and erythema (43.1%), hyperpigmentation (34.5%), redundant skin (3.4%), and fibrofatty tissue (3.4%). Of these, the incidence of anetoderma and fibrofatty tissue were significantly higher in the combined group than in the superficial group ( p = .036 and .033, respectively).
Even small lesions, especially combined-type, often result in cosmetic problems after PDL treatment.
婴儿血管瘤（IH）常导致容貌受损。美国儿科学会临床实践指南建议对大的、高危病变及早进行普萘洛尔干预。相反，对于小的、低危病变的管理策略尚未确定；然而，脉冲染料激光（PDL）常用于治疗这些病变。
研究 PDL 治疗小 IH 病变的临床疗效。
回顾性分析了 53 例 58 个不符合指南中高危病变标准且仅接受 PDL 治疗的小 IH 患者。评估了 IH 的特征和治疗后皮肤残留变化。
47 个病变（81.0%）为浅表型，11 个病变（19.0%）为混合型。最大直径中位数为 10.0 毫米。45 个病变（77.6%）在 PDL 治疗后出现各种皮肤残留变化，包括萎缩（53.5%）、毛细血管扩张和红斑（43.1%）、色素沉着（34.5%）、皮肤多余（3.4%）和纤维脂肪组织（3.4%）。其中，混合型的萎缩和纤维脂肪组织发生率明显高于浅表型（p =.036 和.033）。
即使是小病变，尤其是混合型，PDL 治疗后常导致美容问题。
