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Nunez JH, Strong AL, Comish P, Hespe GE, Harvey J, Sorkin M, Levi B. A Review of Laser Therapies for the Treatment of Scarring and Vascular Anomalies. Adv Wound Care (New Rochelle) 2023; 12:68-84. [PMID: 35951024 DOI: 10.1089/wound.2021.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Significance: Laser use has become part of the gold standard of treatment as an effective adjuvant in multimodal therapy for pathologic scarring caused by burns, trauma, acne, and surgery, as well as vascular anomalies. Understanding indications and applications for laser therapy is essential for physicians to improve patient outcomes. Recent Advances: Since the 1980s, the medical use of lasers has continuously evolved with improvements in technology. Novel lasers and fractionated technologies are currently being studied in the hopes to improve treatment efficacy, while reducing complications. Recent advancements include acne treatment with novel picosecond lasers, new hypertrophic scar therapies with simultaneous laser and intense pulsed light use, and novel systems such as lasers with intralesional optical fiber delivery devices. In addition, optimizing the timing of laser therapy and its use in multimodal treatments continue to advance the field of photothermolysis. Critical Issues: Selecting the correct laser for a given indication is the fundamental decision when choosing a laser balancing effective treatment with minimal complications. This article covers the principles of laser therapy, the preferred lasers used for the treatment of scarring and vascular anomalies, and discusses the current evidence behind these laser choices. Future Directions: To optimize laser therapy, larger randomized control trials and split scar studies are needed. Continued advancement through better randomized controlled studies will help to improve patient outcomes on a broader scale.
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Affiliation(s)
- Johanna H Nunez
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Amy L Strong
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Comish
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Geoffrey E Hespe
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jalen Harvey
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael Sorkin
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Benjamin Levi
- Department of Surgery, Center for Organogenesis Research and Trauma, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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2
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El Saftawy E, Sarhan R, Hamed A, Elhawary E, Sameh A. Lasers for cutaneous lesions: An update. Dermatol Ther 2022; 35:e15647. [PMID: 35714173 DOI: 10.1111/dth.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/30/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
There are several types of medical settings which use lasers. Dermatologists use lasers as it is non-invasive with preferential cosmetic outcomes and finer wound healing. The types of lasers are relying on their wavelengths and delivery systems. Over time, by using several distinct devices and strategies, new lasers have been generated; as a consequence, they are manipulated in a wide range of dermatological settings. In this review, laser applications in various vascular, infectious, and hyperpigmented cutaneous lesions were framed. We aimed to represent the fitness of phototherapy for each condition as well as the overall challenges that face laser. In addition, low-level laser therapy, and laser resurfacing were noted as the marketable line of lasers in the current time for cosmetic purposes.
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Affiliation(s)
- Enas El Saftawy
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Department of Medical Parasitology, Armed Forces College of Medicine, Cairo, Egypt
| | - Rania Sarhan
- Department of Medical Parasitology, Armed Forces College of Medicine, Cairo, Egypt.,Department of Medical Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Hamed
- Department of Medical Parasitology, Armed Forces College of Medicine, Cairo, Egypt
| | - Esraa Elhawary
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Sameh
- Department of Dermatology and Venereology, Armed Forces College of Medicine, Cairo, Egypt
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Phukan J, Sinha A, Das K, Mazumdar M. Lymphangioma circumscriptum of scrotum: a rare case. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_51_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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4
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Cutaneous vascular lesions in the pediatric population: a review of laser surgery applications and lesion-specific device parameters. Lasers Med Sci 2020; 35:1681-1687. [PMID: 32514864 DOI: 10.1007/s10103-020-03058-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
Laser surgery is becoming an increasingly efficacious and customizable treatment modality for the management of pediatric vascular lesions. Proper use requires a thorough understanding of the scientific principles of laser surgery and knowledge of the various lasers available. Moreover, each laser has a multitude of settings that can be employed to properly target the lesion at hand. Each patient will present with unique challenges and variations in the presentation of their vascular lesion. This requires understanding of the most effective laser to use for each lesion and the factors that may alter the desired device settings. Using key search terms, a literature search was conducted on laser surgery for pediatric vascular lesions using PubMed/MEDLINE and Embase for articles published in English or French. Ultimately, 52 articles met our search criteria. The laser indications, limitations, and settings utilized for each type of vascular lesion were compiled for the purposes of this summative review. Laser surgery is an effective and appropriate option for the treatment of certain pediatric vascular lesions. Knowledge of optimal device parameters in every setting is essential to good clinical practice.
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Lin MY, Lin CS, Hu S, Chang JM, Chung WH, Zhang ZY, Chang SC, Huo YP. The application of 595-nm pulsed dye laser for vascular anomalies in a Chinese population: a 10-year experience. J COSMET LASER THER 2018; 21:171-178. [PMID: 30052093 DOI: 10.1080/14764172.2018.1502450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Mao-ying Lin
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
- Medical Cosmetic and Laser center, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Chrang-shi Lin
- Department of Dermatology and Family Medicine, National Yang-Ming University, Taipei, Taiwan
- Dr. Lin Skin Clinic, Taipei, Taiwan
| | - Sindy Hu
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
- Medical Cosmetic and Laser center, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
- Department of Dermatology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Juo-mei Chang
- Medical Cosmetic and Laser center, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
- Department of Plastic and Reconstructive surgery, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Wen-hung Chung
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Zhi-yang Zhang
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Sheng-cheng Chang
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Yu-ping Huo
- Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
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Amodeo I, Cavallaro G, Raffaeli G, Colombo L, Fumagalli M, Cavalli R, Leva E, Mosca F. Abdominal cystic lymphangioma in a term newborn: A case report and update of new treatments. Medicine (Baltimore) 2017; 96:e5984. [PMID: 28225486 PMCID: PMC5569418 DOI: 10.1097/md.0000000000005984] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Lymphatic malformations are benign anomalies derived from the abnormal development of lymphatic channels. Usually asymptomatic, they can cause compression on adjacent structures or present acute complications (bleeding or infection). Small asymptomatic lesions can be conservatively managed since the possibility of spontaneous regressions is described, while symptomatic lesions require active management. Less invasive therapeutic options are now preferred instead of surgery (sclerotherapy, laser therapy). However, there are not uniform therapeutic protocols. CASE REPORT We present the case of a term newborn with an abdominal cystic lymphangioma extending from the umbilical to the right inguinal area, reaching the medial surface of the right tight. Despite its large dimensions, which classically request surgical management, the patient was by chance asymptomatic, and the mass did not determine compression on the surrounding organs. Therefore, conservative management was tried, and a close clinical and radiological follow-up was started. This approach permitted a spontaneous regression of the mass and to avoid major surgical intervention. CONCLUSION Our purpose is to underline the possibility of conservative management of the major multicystic masses and to focus on less invasive therapeutic options, like sclerotherapy, oral therapy, and laser therapy.
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Affiliation(s)
| | | | | | | | | | | | - Ernesto Leva
- Department of Pediatric Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
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Valente K, Montgomery K, Schultenover S, Desouki MM. Acquired vulvar lymphangioma circumscriptum after cervical cancer treatment: Case report. Gynecol Oncol Rep 2016; 16:31-3. [PMID: 27331134 PMCID: PMC4899408 DOI: 10.1016/j.gore.2016.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 03/10/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022] Open
Abstract
Vulvar lymphangioma circumscriptum (LC) is a rare entity which may present as a painful, warty lesion. In contrast to the congenital form, which occurs in children, the acquired form arises in older adults and may be associated with infection, Crohn's disease, or prior pelvic/regional surgery. We present a case of acquired LC of the vulva in a 55-year-old woman who presented with a 3-4 year history of vulvar pain following chemotherapy, radiation, and brachytherapy for cervical cancer. Vulvar shave biopsies followed by excision revealed a thickened dermis with epidermal hyperkeratosis, parakeratosis, elongated rete ridges and dilated lymphatic channels containing eosinophilic material and scattered thrombi. The differential diagnosis for this unusual lesion includes more common conditions such as condyloma acuminatum, fungating squamous cell carcinoma and molluscum contagiosum. It is important to recognize the clinical presentation as well as the distinct histological appearance of this rare benign entity.
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Affiliation(s)
- Kari Valente
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kathleen Montgomery
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Stephen Schultenover
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Mohamed Mokhtar Desouki
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
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Defnet AM, Bagrodia N, Hernandez SL, Gwilliam N, Kandel JJ. Pediatric lymphatic malformations: evolving understanding and therapeutic options. Pediatr Surg Int 2016; 32:425-33. [PMID: 26815877 DOI: 10.1007/s00383-016-3867-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2016] [Indexed: 12/12/2022]
Abstract
Multimodal treatment of lymphatic malformations continues to expand as new information about the biology and genetics of these lesions is discovered, along with knowledge gained from clinical practice. A patient-centered approach, ideally provided by a multidisciplinary medical and surgical team, should guide timing and modality of treatment. Current treatment options include observation, surgery, sclerotherapy, radiofrequency ablation, and laser therapy. New medical and surgical therapies are emerging, and include sildenafil, propranolol, sirolimus, and vascularized lymph node transfer. The primary focus of management is to support and optimize these patients' quality of life. Researchers continue to study lymphatic malformations with the goal of increasing therapeutic options and developing effective clinical pathways for these complicated lesions.
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Affiliation(s)
- Ann M Defnet
- Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5839 S. Maryland, Suite A-426, MC 4062, Chicago, IL, 60637, USA
| | - Naina Bagrodia
- Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5839 S. Maryland, Suite A-426, MC 4062, Chicago, IL, 60637, USA
| | - Sonia L Hernandez
- Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5839 S. Maryland, Suite A-426, MC 4062, Chicago, IL, 60637, USA
| | - Natalie Gwilliam
- Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5839 S. Maryland, Suite A-426, MC 4062, Chicago, IL, 60637, USA
| | - Jessica J Kandel
- Department of Surgery, Section of Pediatric Surgery, Comer Children's Hospital, The University of Chicago Medicine and Biological Sciences, 5839 S. Maryland, Suite A-426, MC 4062, Chicago, IL, 60637, USA.
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Hashizume N, Yagi M, Egami H, Asagiri K, Fukahori S, Ishii S, Saikusa N, Yoshida M, Masui D, Tanaka Y. Clinical Efficacy of Herbal Medicine for Pediatric Lymphatic Malformations: A Pilot Study. Pediatr Dermatol 2016; 33:191-5. [PMID: 26777254 PMCID: PMC5066663 DOI: 10.1111/pde.12777] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Lymphatic malformations (LMs) are congenital malformations of the lymphatic system that commonly affect the head and neck region and cause marked cosmetic and functional complications. In this pilot study, we present eight children with LMs treated using an herbal medicine for this indication. METHODS Between January 2009 and May 2014, eight children (four boys, four girls) with LMs were treated using oral administration of an herbal medicine, Eppikajyutsuto (TJ-28; Tsumura, Tokyo, Japan), as monotherapy. RESULTS Four of the cases were macrocystic and four were mixed micro- and macrocystic. The mean treatment duration was 7.2 ± 2.9 months (range 5-12 mos). The mean LM volume shrinkage on magnetic resonance imaging was 54.5 ± 38.3% (macrocystic 73.6 ± 27.0%; mixed micro- and macrocystic 35.4 ± 41.5%). One of four macrocystic lesions had a marked reduction, two had a moderate reduction, and one had no response. A marked reduction was observed in three of the four mixed micro- and macrocystic cases; the other mixed cystic case had no response. The treatment was well tolerated, without severe adverse events. CONCLUSIONS This preliminary study demonstrates the beneficial effects of TJ-28. Further evaluations of this therapeutic modality are warranted.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Minoru Yagi
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
- Department of Innovative Kampo MedicineKurume University School of MedicineKurumeFukuokaJapan
| | - Hideaki Egami
- Department of Innovative Kampo MedicineKurume University School of MedicineKurumeFukuokaJapan
| | - Kimio Asagiri
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Suguru Fukahori
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Shinji Ishii
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Nobuyuki Saikusa
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Motomu Yoshida
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Daisuke Masui
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
| | - Yoshiaki Tanaka
- Department of Pediatric SurgeryKurume University School of MedicineKurumeFukuokaJapan
- Division of Medical Safety ManagementKurume University School of MedicineKurumeFukuokaJapan
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10
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Abstract
Lymphangioma circumscriptum (LC) is a form of lymphangioma characterised by benign dilation of lymphatic channels, which affects the skin and subcutaneous tissues. The most common sites of LC are mucosa of mouth, tongue, groin, axilla, trunk and proximal region of extremities. Vulva is a rare site of LC. In this report, we are presenting a case of LC of vulva occurring in a 60-year-old female without any obvious reason. The patient presented with multiple genital wart-like papular lesions in the vulva. Biopsy of lesion reveals LC. She was treated with vulvectomy and showed no sign of recurrence till date.
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Affiliation(s)
- Anuradha Sinha
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Jyoti Prakash Phukan
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Shilpa Jalan
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
| | - Subrata Pal
- Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India
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Abstract
PURPOSE OF REVIEW To review the literature on lymphatic malformations and to provide current opinion about the management of these lesions. RECENT FINDINGS Current treatment options include nonoperative management, surgery, sclerotherapy, radiofrequency ablation, and laser therapy. New therapies are emerging, including sildenafil, propranolol, sirolimus, and vascularized lymph node transfer. The primary focus of management centers on the patient's quality of life. SUMMARY Multimodal treatment of lymphatic malformations continues to expand as new information about the biology and genetics of these lesions is discovered, in addition to knowledge gained from clinical practice. A patient-centered approach should guide timing and modality of treatment. Continued study of lymphatic malformations will increase and solidify a treatment algorithm for these complicated lesions.
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12
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Fioramonti P, Maruccia M, Ruggieri M, Onesti MG. A rare case of lymphangioma in the gluteal region: surgical treatment combined with sclerotherapy and laser therapy. Aesthetic Plast Surg 2013; 37:960-4. [PMID: 23949129 DOI: 10.1007/s00266-013-0201-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 07/16/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Lymphangioma, a rare benign malformation of lymphatic channels, is among the surgically treatable diseases of the lymphatic vessels. However, damage to surrounding structures together with incomplete resection due to adjacent organ infiltration and a high recurrence rate have encouraged the search for alternative treatments. This study aimed to identify the best therapeutic management for this difficult-to-treat disease. METHODS This report describes a case of congenital lymphangioma in the gluteal region in a young woman. First, sclerotherapy of the lymphangioma was performed and then surgical excision of residual lesions. Finally, as a third therapeutic step, the patient also was subjected to a cycle of laser therapy with the aim of further improving the appearance of the gluteal region. Pulsed dye laser was used to remove cutaneous dyschromias, and an erbium:yttrium-aluminum-garnet laser was used to remove surface irregularities and obtain better skin smoothness. The outcome assessments included standardized photography, the physician's global assessment, the patient's satisfaction scores, and magnetic resonance imaging of the gluteal region. RESULTS All the lesions of lymphangioma were removed. After the last laser treatment, the skin of the entire treated region was eutrophic and uniform in color, and it appeared to be smooth and soft when palpated. The patient was satisfied with the clinical and aesthetic results achieved. CONCLUSIONS The combination of sclerotherapy with surgery can be a good solution for the treatment of lymphangioma. The authors also propose laser therapy as an additional therapeutic approach that may follow surgery or sclerotherapy with the aim of improving the skin trophism and the appearance of the affected region.
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13
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Shumaker PR, Dela Rosa KM, Krakowski AC. Treatment of lymphangioma circumscriptum using fractional carbon dioxide laser ablation. Pediatr Dermatol 2013; 30:584-6. [PMID: 23758048 DOI: 10.1111/pde.12165] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphangioma circumscriptum remains a challenging entity to treat given anatomic considerations and a significant tendency for recurrence regardless of the modality selected. Surgical excision offers the greatest potential for definitive management but is often beset by procedural morbidity and suboptimal cosmetic outcomes. A range of palliative options have been reported for the treatment of lymphangioma circumscriptum, with varying degrees of associated efficacy and morbidity. This report describes the novel use of fractional carbon dioxide laser ablation for the treatment of lymphangioma circumscriptum, with promising cosmetic results and durable symptomatic relief.
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Affiliation(s)
- Peter R Shumaker
- Department of Dermatology, Naval Medical Center, San Diego, California
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Savas JA, Ledon J, Franca K, Chacon A, Zaiac M, Nouri K. Carbon Dioxide Laser for the Treatment of Microcystic Lymphatic Malformations (Lymphangioma Circumscriptum): A Systematic Review. Dermatol Surg 2013; 39:1147-57. [DOI: 10.1111/dsu.12220] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tsilika K, Bahadoran P, Passeron T. Superficial Lymphangioma Treated with Fractional Ablative Laser: A Case Report with Clinical and Reflectance Confocal Microscopy Evaluation. Dermatol Surg 2013; 39:141-3. [DOI: 10.1111/j.1524-4725.2012.02567.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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França K, Chacon A, Ledon J, Savas J, Izakovic J, Nouri K. Lasers for cutaneous congenital vascular lesions: a comprehensive overview and update. Lasers Med Sci 2012; 28:1197-204. [DOI: 10.1007/s10103-012-1220-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 10/15/2012] [Indexed: 12/20/2022]
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Del Pozo J, Gómez-Tellado M, López-Gutiérrez J. Malformaciones vasculares en la infancia. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:661-78. [DOI: 10.1016/j.ad.2011.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 12/18/2011] [Accepted: 12/25/2011] [Indexed: 12/20/2022] Open
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18
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Vascular Malformations in Childhood. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2012.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Since its introduction in 1967, laser therapy has benefited patients and physicians alike. After the first clinical application by Goldman (Anderson RR, Parrish JA. Science 1983;220:524-527), laser therapy has become indispensable in the management of vascular birthmarks. In selecting a proper balance of wavelength, pulse duration, and energy density (fluence), the physician can mold laser energy to effectively manage lesions once considered untreatable. Now, the vast array of lesions amenable to laser therapy continues to expand. By advancing our understanding of both laser technology and vascular lesion biology, the goal of providing optimal clearance with minimal morbidity moves ever closer.
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Affiliation(s)
- Patrick D Cole
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
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20
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Schneider LF, Chen CM, Zurada JM, Walther R, Grant RT. Surgical management of a dermal lymphatic malformation of the lower extremity. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2011; 16:236-8. [PMID: 19949506 DOI: 10.1177/229255030801600410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dermal lymphatic malformations are rare congenital hamartomas of superficial lymphatics characterized by high recurrence rates after excision. The standard therapy for a single lesion is surgical excision with wide margins, which reduces recurrence but can have a potentially unacceptable aesthetic outcome. A case of a 24-year-old woman with a 6 cm x 5 cm dermal lymphatic malformation on her right thigh, diagnosed by clinical history, physical examination, magnetic resonance imaging and pathological findings, is reported. The patient underwent wide local excision with split-thickness skin grafting. After pathological examination revealed negative margins, the patient underwent tissue expander placement and excision of the skin graft with primary closure. The lesion did not recur, and the patient achieved a satisfactory aesthetic result. The present case represents the first report of the use of tissue expanders to treat dermal lymphatic malformations in the lower extremity and demonstrates a safe, staged approach to successful treatment.
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Affiliation(s)
- Lisa F Schneider
- Division of Plastic Surgery, New York-Presbyterian Hospital, New York, New York, USA
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21
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Bongiorno MR, Aricò M. Preliminary communication: imiquimod in mixed capillary/lymphatic malformation. Dermatol Ther 2009; 21 Suppl 2:S39-42. [PMID: 18837733 DOI: 10.1111/j.1529-8019.2008.00232.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present authors reported a 14-year-old white boy who visited the present authors' dermatology department in January 2004. Physical examination revealed multiple translucent and hemorrhagic vesicles and skin-colored nodules on the chin. The lesion had grown slowly in size over the previous 7 years. The objective of this study is to estimate the exact mechanism of action of topical imiquimod on mixed capillary/lymphatic malformation. After 4 weeks of therapy the lesions were less protuberant. At the follow-up examination after a further 2 months of therapy, there was partial clinical regression of the capillary component with a return to normal skin color. One month after termination of therapy the lesions had completely regressed and there was no evidence of recurrence of the hemangiomatous section. The present authors' case suggests the efficacy of the use of topical imiquimod and this therapeutic modality may be of particular benefit in superficial type of capillary/lymphatic malformation, in which the destructive intervention may be undesirable.
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Affiliation(s)
- M R Bongiorno
- Department of Dermatology, University of Palermo, Italy.
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22
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Beà-Ardébol S, Boixeda P, Bagazgoitia L, Santiago Sánchez-Mateos JL, Pérez-Carmona L, Jaén P. Management of superficial lymphangiectasias with laser: report of five patients. J Eur Acad Dermatol Venereol 2008; 23:450-1. [PMID: 18624841 DOI: 10.1111/j.1468-3083.2008.02894.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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BOND JEREMY, BASHEER MOHAMMEDHAJ, GORDON DEREK. Lymphangioma Circumscriptum: Pitfalls and Problems in Definitive Management. Dermatol Surg 2007; 34:271-5. [DOI: 10.1111/j.1524-4725.2007.34054.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stoss S, Kalbermatten DF, Robertson A, Bruder E, Rasmus M, Gambazzi F, Pierer G. Large cystic tumour at the chest wall mimicking an echinococcosis: a case report. J Plast Reconstr Aesthet Surg 2007; 61:e13-6. [PMID: 18060851 DOI: 10.1016/j.bjps.2007.10.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Revised: 04/23/2007] [Accepted: 10/18/2007] [Indexed: 10/22/2022]
Abstract
The authors report an atypical late onset of a big axillary lymphatic malformation in a 41-year-old male. Considering the patient's history and clinical findings at first presentation, the swelling was highly suspicious for malignancy or cystic echinococcosis. A consequent CT showed non infiltrative growth with inhomogeneous density but remained non conclusive regarding diagnosis. Subsequently incision biopsy revealed lymphatic tissue and raised suspicion for lymphatic malformation. The tumour was excised completely and showed no recurrence in a 1-year follow up. Late onset lymphatic malformations can mimic malignant tumours or other rare conditions such as echinococcosis which has to be taken into consideration as differential diagnosis especially in known areas of hydatid diseases.
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Affiliation(s)
- S Stoss
- Department of Plastic and Reconstructive Surgery, University of Basel, Switzerland.
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Thissen CACB, Sommer A. Treatment of lymphangioma circumscriptum with the intense pulsed light system. Int J Dermatol 2007; 46 Suppl 3:16-8. [DOI: 10.1111/j.1365-4632.2007.03503.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Berwald C, Salazard B, Casanova D, Bardot J, Magalon G. Indications des lasers dans le traitement des malformations lymphatiques. ANN CHIR PLAST ESTH 2006; 51:429-32. [PMID: 17007982 DOI: 10.1016/j.anplas.2006.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cutaneous dermatologic lesions of LM, in type of superficial, translucent, localized or diffuse vesicles, are accessible to laser treatment. The useful lasers are essentially laser CO(2), and rarely pulsed dye laser and the Nd: YAG. Treatment by laser allows to obtain the ablation of vesicles by limiting aftereffects (scare) and so to dry up the transcutaneous lymphatic liquid. However laser has no action on the deep constituent of the LM and it's why medium and long term recurrences are inevitable. Finally, the indication of the laser must be retained only as a supplement to the surgery and has to be done by experimented persons.
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Affiliation(s)
- C Berwald
- Service de chirurgie plastique reconstructrice et esthétique du Professeur-Magalon, hôpital de La Conception, boulevard Baille, 13005 Marseille, France.
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Lapidoth M, Ackerman L, Amitai DB, Raveh E, Kalish E, David M. Treatment of Lymphangioma Circumscriptum with Combined Radiofrequency Current and 900 nm Diode Laser. Dermatol Surg 2006; 32:790-4. [PMID: 16792643 DOI: 10.1111/j.1524-4725.2006.32162.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Laser treatment of lymphangioma circumscriptum is a major challenge because of the persistent nature of the disease and the large variations in lesion size, depth, and anatomic location. OBJECTIVE To determine the safety and effectiveness of electro-optical synergy, a new technology that combines a 900 nm diode laser with radiofrequency current, for the treatment of lymphangioma circumscriptum. METHODS Six patients with Fitzpatrick skin types II to IV were treated for lymphangioma circumscriptum with 1 to 3 sessions of simultaneous radiofrequency energy (60-80 J/cm3) and optical diode laser energy (fluence 90-100 J/cm2). Lesion clearance was evaluated by three specialists on the basis of digital photographs taken before the first treatment and 1 and 2 months after the last treatment. RESULTS Results were rated as "excellent" in four patients and "good" in two patients. Transient swelling, erythema, and pain were present in all patients, and ulcers and scarring in two patients. CONCLUSION The combination of laser light and radiofrequency energy is effective and relatively safe for the treatment of lymphangioma circumscriptum. It provides additional heating of the blood vesicles without increasing the laser intensity and allows the clinician to treat the clear lymphatic component, which lacks a specific optical chromophore. Side effects are tolerable.
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Affiliation(s)
- Moshe Lapidoth
- Department of Dermatology, Rabin Medical Center, Petah Tikva, Israel.
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Treatment of Lymphangioma Circumscriptum with Combined Radiofrequency Current and 900 nm Diode Laser. Dermatol Surg 2006. [DOI: 10.1097/00042728-200606000-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang LC, Krunic AL, Medenica MM, Soltani K, Busbey S. Treatment of hemorrhagic lymphatic malformation of the tongue with a pulsed-dye laser. J Am Acad Dermatol 2006; 52:1088-90. [PMID: 15928635 DOI: 10.1016/j.jaad.2005.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hemorrhagic lymphatic malformation (formerly called hemolymphangioma) of the tongue is an uncommon malformation that may pose both functional and cosmetic problems for the patient. The challenge has been to find a conservative treatment with low morbidity and better results than those achieved with surgical excision, which has been the mainstay of therapy. We report a case of successful treatment of a hemorrhagic lymphatic malformation of the tongue with a variable-pulse 595-nm pulsed-dye laser (Vbeam; Candela Corp, Wayland, Mass). In this patient, pulsed-dye laser treatment of the hemorrhagic lymphatic malformation achieved satisfactory functional and cosmetic outcomes. Its use in superficial vascular lesions of the mucosa should be considered.
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Affiliation(s)
- Linda C Wang
- Department of Dermatology, Brigham & Women's Hospital, Boston, Massachusetts, USA
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Park CO, Lee MJ, Chung KY. Treatment of Unusual Vascular Lesions: Usefulness of Sclerotherapy in Lymphangioma Circumscriptum and Acquired Digital Arteriovenous Malformation. Dermatol Surg 2006; 31:1451-3. [PMID: 16416619 DOI: 10.2310/6350.2005.31216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sclerotherapy is used in venous malformations and hemangiomas, as well as chronic venous insufficiency and hemorrhoids. OBJECTIVE To report on the usefulness of sclerotherapy in the treatment of unusual vascular lesions, such as lymphangioma circumscriptum and acquired digital arteriovenous malformation. METHODS Two unusual cases were treated with a sclerosant, sodium tetradecyl sulfate. RESULTS The patients were almost cleared with several treatments of sclerotherapy. CONCLUSION Sclerotherapy can be recommended as an effective treatment method for unusual vascular lesions, such as lymphangioma circumscriptum and acquired digital arteriovenous malformation.
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Affiliation(s)
- Chang Ook Park
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Treatment of Unusual Vascular Lesions. Dermatol Surg 2005. [DOI: 10.1097/00042728-200511000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Edwards PD, Rahbar R, Ferraro NF, Burrows PE, Mulliken JB. Lymphatic Malformation of the Lingual Base and Oral Floor. Plast Reconstr Surg 2005; 115:1906-15. [PMID: 15923836 DOI: 10.1097/01.prs.0000165071.48422.a4] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lymphatic malformation of the tongue and floor of the mouth is associated with chronic airway problems, recurrent infection, and functional issues related to speech, oral hygiene, and malocclusion. There are no accepted anatomic guidelines or treatment protocols. METHODS This retrospective review focused on anatomic extent, treatment, complications, and airway management in 31 patients with lymphatic malformation of the lingual base and oral floor. RESULTS Involved adjacent structures included the neck (77 percent), mandible (41 percent), face (42 percent), lips (10 percent), pharynx (45 percent), and larynx (26 percent). Fifty-eight percent of patients required tracheostomy during infancy; decannulation was possible in two-thirds of these patients. Management included resection alone (42 percent), resection and sclerotherapy (26 percent), resection and laser coagulation (16 percent), sclerotherapy and laser coagulation (16 percent), and resection and radiofrequency ablation (3 percent). Resection involved the neck (58 percent), floor of the mouth (52 percent), and tongue (42 percent); there were often multiple procedures. Aspiration was tried with little success in 10 percent of patients. Virtually all patients had residual abnormal lymphatic tissue. Complications and posttherapeutic problems included infection (81 percent), neural damage (27 percent), difficulty in speech (23 percent), feeding problems (10 percent), and seroma or hematoma (6 percent). Associated dental/orthognathic conditions, particularly prognathism and anterior open bite, were documented in one-third of patients. CONCLUSIONS The initial step in the protocol is control of the neonatal airway. Staged cervical resection is undertaken in late infancy to early childhood; resection should also include abnormal tissue in the oral floor. Sclerotherapy is primarily for macrocystic disease or secondarily for recurrent cysts following partial extirpation. Vesicles of the mucous membranes and dorsal tongue are treated either by sclerotherapy, laser (carbon dioxide, yttrium-aluminum-garnet, or potassium-titanyl-phosphate), or radiofrequency ablation. Reduction for macroglossia is indicated for persistent protrusion or to allow correction of malocclusion. Embolization controls lingual bleeding. Orthognathic procedures are undertaken at the appropriate age, only after lingual size and position are acceptable.
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Affiliation(s)
- Paul D Edwards
- Craniofacial Center, Division of Plastic and Oral Surgery, Department of Radiology, Children's Hospital, Harvard Medical School, Boston, Mass, USA
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