Successful Treatment of Lower Extremity Telangiectasias Using 585-nm Pulsed-Dye Laser at Low Fluence Combined With Optical Coherence Tomography: A Case Report

Ali Rajabi-Estarabadi, Caiwei Zheng, Natalie Williams, Samuel C. Smith, Keyvan Nouri, Robert S. Kirsner

Research output: Contribution to journalArticle

Abstract

Background: Significant advances have been made in using lasers and intense pulse light sources to treat common vascular lesions such as telangiectasias. However, the treatment of leg telangiectasia, specifically, is more challenging because it involves the clearing of smaller veins as well as the larger feeding veins. The latest guidelines recommend use of short wavelength pulse-dyed lasers (PDL) as an option to treat telangiectasia cases that are unresponsive to sclerotherapy. Methods: A 29-year-old white woman presented with persistent telangiectasia, with multiple telangiectasias ranging from 1 cm to 20 cm in size involving the dorsal feet and both ankles and legs, which developed 10 years prior, associated with paresthesia. Test spots were treated with a 585-nm pulsed dye laser with various energy settings, and treatment was performed at 5.5 J/cm2 with spot size 10 mm and 0.5ms pulse duration. Results: Near complete clearance was achieved 1 month after the single treatment without adverse effects. Optical coherence tomography (OCT) imaging demonstrated a reduction of cutaneous blood flow after treatment. Discussion: We report successful treatment despite using settings that were previously reported to lack efficacy. This treatment resulted in considerable improvement in aesthetics and symptomatology. Also, OCT confirmed decreased vascular flow and bulging. Conclusion: Our results suggest there is still much to learn about the use of PDL in treating telangiectasias of the lower extremities, and that the ideal parameters warrant further investigation. Moreover, the novel use of OCT in auxiliary imaging for identification of treatment spots, as well as monitoring response at a microvascular level, holds great potential for wider application. J Drugs Dermatol. 2019;18(11):1180-1182.

Original languageEnglish (US)
Pages (from-to)1180-1182
Number of pages3
JournalJournal of drugs in dermatology : JDD
Volume18
Issue number11
StatePublished - Nov 1 2019

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Dye Lasers
Telangiectasis
Optical Coherence Tomography
Lower Extremity
Pulse
Lasers
Therapeutics
Blood Vessels
Veins
Leg
N,N-dimethyl-3,3-diphenyl-1-methylallylamine
Sclerotherapy
Paresthesia
Esthetics
Ankle
Foot
Guidelines
Light
Skin
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Dermatology

Cite this

Successful Treatment of Lower Extremity Telangiectasias Using 585-nm Pulsed-Dye Laser at Low Fluence Combined With Optical Coherence Tomography : A Case Report. / Rajabi-Estarabadi, Ali; Zheng, Caiwei; Williams, Natalie; Smith, Samuel C.; Nouri, Keyvan; Kirsner, Robert S.

In: Journal of drugs in dermatology : JDD, Vol. 18, No. 11, 01.11.2019, p. 1180-1182.

Research output: Contribution to journalArticle

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