The article by van Gemert et al1 in this issue of the Archives represents an interesting theoretical consideration of the applicability of the carbon dioxide laser to the treatment of port-wine stains. However, it is really more a review of reported histologic changes in skin after specific types of laser injury than it is in any sense an article based on the authors' own experimentation or comparison of modes of therapy in treating a series of similar port-wine stains. Additionally, it can be argued, on a point-by-point basis, that various inaccuracies exist in their discussion.
The authors' premise that the incidence of hypertrophic scarring is most likely dependent on destruction of the epidermis and upper dermis forms the basis for their criticism of the carbon dioxide laser in the treatment of port-wine stains. Unfortunately, this is a totally invalid argument since there is little or no support for that
Ratz JL, Bailin PL. The Case for Use of the Carbon Dioxide Laser in the Treatment of Port-wine Stains. Arch Dermatol. 1987;123(1):74–75. doi:10.1001/archderm.1987.01660250080023
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