Argon and neodymium YAG laser therapy of dark nodular port wine stains in older patients.

Thirty-seven patients of mean age 52 with large dark nodular port wine stains were treated with argon and neodymium YAG lasers. The level of patient satisfaction was high (mean 7.1 on scale of 10) despite residual color in 36 of 37 patients. It was possible to accomplish flattening of the lesion and removal of nodules in all patients. In four patients, it was necessary to use neodymium YAG laser for removal of residual large vascular nodules following previous argon therapy. Twenty-nine patients required a mean number of 1.6 retreatments for residual tufts of vessels. An unusual finding was that of recurrent color deepening of lesion in three patients after initial improvement. This recurrence responded to treatment. Spontaneous bleeding or bleeding initiated by trauma such as shaving was a problem noted in 13 out of 37 patients.