Topical Adjuncts to Pulsed Dye Laser for Treatment of Port Wine Stains: Review of the Literature

BACKGROUND Port wine stains (PWS) pose a therapeutic challenge. Pulsed dye laser (PDL) is the treatment of choice; however, treatment is often ineffective and recurrences are common. OBJECTIVE This article provides a review of topical therapies that have been investigated to improve efficacy of PDL for the treatment of PWS. MATERIALS AND METHODS A literature search was performed through PubMed, EMBASE, Web of Science, and CINAHL, using the search terms "port wine stain," "pulsed dye laser," and "topical." RESULTS Clinical trials have investigated the topical agents, timolol, imiquimod, and rapamycin (RPM) in combination with PDL for the treatment of PWS. Topical timolol with PDL failed to show improved efficacy compared with PDL alone. Two clinical trials using imiquimod and PDL showed enhanced blanching of PWS compared with controls. Rapamycin and PDL were more effective than controls for facial PWS, but not for nonfacial PWS. CONCLUSION Topical imiquimod and RPM have shown some efficacy in treating PWS with PDL, but to date there is no topical adjuvant to PDL that reliably improves results for PWS. Address correspondence and reprint requests to: Shari R. Lipner, MD, PhD, 1305 York Avenue, New York, NY 10021, or e-mail: shl9032@med.cornell.edu The author has indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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