In this issue of JAMA Dermatology, Jeon and colleagues1 report on the safety and efficacy of pulsed dye laser (PDL) use in the treatment of port-wine stains (PWS) in a cohort of nearly 200 infants treated without the use of general anesthesia. The authors retrospectively analyzed photographs from short-term follow-up and found a high rate of excellent clearance and no major cutaneous adverse events. They emphasize the feasibility of treating young infants without general anesthesia, an approach that is increasingly relevant because of recent concerns raised about possible developmental effects of general anesthesia in children younger than 3 years. Although the authors’ treatment approach is similar to ours in many respects, there are several aspects of their study that are worthy of further discussion. We base our comments on published literature on this topic as well our experiences as pediatric dermatologists with a busy laser practice that has used PDL for PWS treatment since 1989 (in the case of the senior author).
Mathes EF, Frieden IJ. Early Use of Laser for Port-Wine Stains: Timing, Efficacy, and Shared Decision Making. JAMA Dermatol. 2019;155(4):421–423. doi:https://doi.org/10.1001/jamadermatol.2018.5189
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