Clinical Efficacy Study of 755 nm Picosecond Laser Combined With 595 nm Pulsed Dye Laser in the Treatment of Port-Wine Stain.

Abstract

Background: Port-wine stain (PWS) is a disfiguring vascular anomaly characterized by persistent cutaneous erythema and progressive tissue hyperplasia. Although pulsed dye laser (PDL) is the first-line treatment and alleviates certain clinical manifestations, incomplete lesion clearance and high recurrence rates persist in some patients, posing significant therapeutic challenges.

Objective: To evaluate the efficacy and safety of sequential therapy with a 755 nm picosecond laser (PSL) combined with 595 nm PDL versus 595 nm PDL alone in treating PWS.

Methods: Thirty-four patients with PWS were enrolled. Lesions were randomly divided into paired subregions (PDL and PDL + PSL) using a subregional control design. Efficacy was assessed through objective and subjective measures: standardized clinical and dermoscopic images were used to quantify visual scores and clearance rates; reflectance confocal microscopy (RCM) quantitatively analyzed changes in vascular density and diameter; patient satisfaction and adverse reactions were also evaluated.

Results: The PSL + PDL group showed significantly greater improvement in visual assessment scores, lesion area clearance, vascular density, vascular diameter, and patient satisfaction compared to the PDL group (all p < 0.05). While no statistically significant difference was observed in adverse event incidence rates between the two treatment modalities (p > 0.05), both regimens exhibited favorable safety profiles.

Conclusion: The PSL + PDL regimen shows significantly superior efficacy over PDL alone, thus presenting a promising and advanced therapeutic alternative for PWS treatment.