Systemic effects of photothermolysis of large port-wine stains in infants and children

• Published in: Plastic and reconstructive surgery (1963) Vol. 93; no. 6; p. 1150
• Main Authors: Eppley, B L, Sadove, A M
• Format: Journal Article
• Language: English
• Published: United States 01-05-1994
• Subjects: Child, Preschool; Face; Female; Hamartoma - blood; Hamartoma - therapy; Haptoglobins - analysis; Humans; Infant; Laser Therapy; Male; Phototherapy; Skin - blood supply; Skin Diseases - blood; Skin Diseases - therapy
• ISSN: 0032-1052
• DOI: 10.1097/00006534-199405000-00007

Fifteen patients who were 5 years of age or younger with large port-wine stain lesions were studied after flashlamp pulsed-dye laser therapy. Matched serum haptoglobin assays were obtained immediately prior to and after the laser treatments intraoperatively. Combined with the testing for hemosiderin from urine samples collected within 2 hours postoperatively, the amount of intravascular hemolysis present after early photothermolysis was assessed. Mean preoperative haptoglobin levels were within normal ranges (116 +/- 13 mg/dl), which then averaged a 9.5 percent decrease (105 +/- 8 mg/dl) at the conclusion of laser therapy. The decline in haptoglobin levels was higher in the youngest patient but did not exceed the renal threshold for hemoglobin. No evidence of hemoglobin was found in the urine or urine sediment of any patient. These results indicate that although hemoglobinemia does occur after port-wine stains ablation with the flashlamp pulsed-dye laser, the level of intravascular hemolysis obtained is not injurious to the infant or child with large cutaneous involvement. Flashlamp pulsed-dye laser therapy, therefore, may be undertaken safely at very young ages to obtain maximum clinical and psychological benefit.