Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands.
Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands.
Dermatology. 2023;239(5):768-781. doi: 10.1159/000530609. Epub 2023 Jul 13.
Patients with capillary malformations (CMs) may undergo medical tattooing (MT) as an alternative to laser therapy. But little is known about treatment results and impact from the patients' perspective.
In this cross-sectional digital survey study, we evaluated the patient-reported outcomes of MT for CMs.
MT practices were identified via the Dutch Association of Skin Therapists and Google. These practices invited all their CM patients who had undergone MT between January 2011 and September 2021 to participate. Baseline and treatment characteristics, tattooing effectiveness, patient satisfaction with treatment outcomes, and complications were evaluated using a custom-made online survey. Quality of life was assessed with the Dermatology Life Quality Index (DLQI) questionnaire. Factors associated with treatment effectiveness and patient satisfaction were identified via bivariate analysis and ordinal logistic regression analysis.
Most of the 89 respondents were female (69%). Almost all CMs were located on the face (90%) and mainly (dark) red (74%). Nearly all patients had undergone laser therapy (91%). Median number of tattooing sessions was 5 (IQR: 4.0-8.0). Thirty-seven percent of the patients perceived >75% color reduction. Younger patients were more likely to obtain lower treatment effectiveness (OR 0.44, 95% CI: 0.20-0.97). Most patients (83%) were satisfied with treatment results. Patients with lighter (OR 0.30, 95% CI: 0.13-0.72), non-facial (OR 0.15, 95% CI: 0.03-0.89), and hypertrophic CMs (OR 0.30, 95% CI: 0.11-0.82) were less likely to be satisfied with treatment outcomes. Patients with lighter skin types were more satisfied (OR 2.89, 95% CI: 1.23-6.80). Complications included transient pain (23%), bleeding (3.4%), hypertrophic scarring (1.1%), hypopigmentation (1.1%), and a halo around the tattoo (1.1%).
MT seems a valid alternative treatment in addition to laser therapy for CMs, with mild complications. Most patients are (very) satisfied with treatment results, while color reduction is incomplete. Hence, it seems appropriate to decide together with patients whether or not to use MT as primary treatment or secondary to laser therapy.
毛细血管畸形（CMs）患者可能会选择医学纹身（MT）作为激光治疗的替代方法。但是，从患者的角度来看，对于 MT 的治疗效果和影响知之甚少。
在这项横断面数字调查研究中，我们评估了 MT 治疗 CMs 的患者报告结果。
通过荷兰皮肤治疗师协会和谷歌确定 MT 实践。这些实践邀请了自 2011 年 1 月至 2021 年 9 月期间接受过 MT 的所有 CMs 患者参加。使用定制的在线调查评估基线和治疗特征、纹身效果、患者对治疗结果的满意度以及并发症。使用皮肤病生活质量指数（DLQI）问卷评估生活质量。通过双变量分析和有序逻辑回归分析确定与治疗效果和患者满意度相关的因素。
89 名受访者中大多数为女性（69%）。几乎所有的 CMs 都位于面部（90%），主要为（深）红色（74%）。几乎所有患者都接受过激光治疗（91%）。中位数纹身次数为 5 次（IQR：4.0-8.0）。37%的患者认为颜色减少了>75%。年轻患者获得的治疗效果更差（OR 0.44，95%CI：0.20-0.97）。大多数患者（83%）对治疗结果满意。皮肤较浅（OR 0.30，95%CI：0.13-0.72）、非面部（OR 0.15，95%CI：0.03-0.89）和肥大性 CMs（OR 0.30，95%CI：0.11-0.82）的患者不太可能对治疗结果满意。皮肤较浅的患者满意度更高（OR 2.89，95%CI：1.23-6.80）。并发症包括短暂疼痛（23%）、出血（3.4%）、肥厚性瘢痕形成（1.1%）、色素减退（1.1%）和纹身周围出现晕环（1.1%）。
MT 似乎是 CMs 激光治疗的有效替代方法，且并发症较轻。大多数患者对治疗结果非常满意，但颜色减少不完全。因此，与患者一起决定是否将 MT 作为主要治疗方法或激光治疗的辅助方法似乎是合适的。
