Surgical Care
Pulsed dye lasers with a wavelength of 585 nm and a pulse width of 450 microseconds offer a safe and effective treatment of telangiectasias. Use caution in the thinner skin in the neck area to avoid blistering and potential scarring. Cliff and Harland reported their results with the use of pulsed-dye laser in the treatment of 5 patients with unilateral nevoid telangiectasia. [16] They found that pulsed-dye laser was an effective treatment, but they noted a recurrence of lesions in all cases. Sharma and Khandpur, on the other hand, found no recurrence in their 6 Indian patients treated with the 585-nm pulsed dye laser. [17] A moderate response was achieved in all patients, and reversible pigmentary changes were the major adverse effects.
Pulsed-dye lasers with longer wavelengths and pulse widths are now available for larger vessels.
Pulsed KTP (potassium-titanyl-phosphate) 532-nm, long-pulsed alexandrite 755-nm, pulsed diode 800- to 930-nm, long-pulsed Nd:YAG 1064-nm, and filtered broad-spectrum pulsed light sources have been used for vascular lesions, with less postoperative purpura.
In a case from China, an 8-year-old male patient with a 4-year history of unilateral nevoid telangiectasia was previously treated unsuccessfully with pulsed dye laser. The patient then underwent hemoporfin-mediated photodynamic therapy with good improvement in symptoms and no recurrence during 14 months of observation. [18]
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Unilateral nevoid telangiectasia on the neck.
