Cutaneous vascular lesions in the pediatric population: a review of laser surgery applications and lesion-specific devic
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REVIEW ARTICLE
Cutaneous vascular lesions in the pediatric population: a review of laser surgery applications and lesion-specific device parameters Thomas Vazquez 1,2,3
&
Mahtab Forouzandeh 2 & Pooja Gurnani 1,2 & Shifa Akhtar 1 & Keyvan Nouri 2
Received: 2 February 2020 / Accepted: 1 June 2020 # Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Laser surgery is becoming an increasingly efficacious and customizable treatment modality for the management of pediatric vascular lesions. Proper use requires a thorough understanding of the scientific principles of laser surgery and knowledge of the various lasers available. Moreover, each laser has a multitude of settings that can be employed to properly target the lesion at hand. Each patient will present with unique challenges and variations in the presentation of their vascular lesion. This requires understanding of the most effective laser to use for each lesion and the factors that may alter the desired device settings. Using key search terms, a literature search was conducted on laser surgery for pediatric vascular lesions using PubMed/MEDLINE and Embase for articles published in English or French. Ultimately, 52 articles met our search criteria. The laser indications, limitations, and settings utilized for each type of vascular lesion were compiled for the purposes of this summative review. Laser surgery is an effective and appropriate option for the treatment of certain pediatric vascular lesions. Knowledge of optimal device parameters in every setting is essential to good clinical practice. Keywords Pediatric . Dermatology . Vascular tumor . Vascular malformation . Laser . Laser surgery
Introduction The management of vascular lesions in the pediatric population can become complex, requiring an interdisciplinary approach and meticulous treatment considerations. Among the treatment modalities available, laser surgery has gained recognition as an effective and minimally invasive treatment option in the management of pediatric vascular lesions. Accordingly, it is important that dermatologists who are treating vascular lesions in the pediatric population are aware of the multiple laser options available to them and their respective indications, limitations, and recommended device parameters. There is a wide variety of distinct vascular lesions, and each kind of lesion may present during different stages of
development. An individualized approach to these vascular lesions requires careful consideration of many factors such as age, Fitzpatrick skin type, lesion type, location, depth, and clinical progression. Consideration of all of these factors will aid in the selection of the appropriate laser and corresponding device parameters, such as wavelength, pulse duration, fluence, and spot size, as well as the recommended number of treatment sessions. This review aims to guide clinical practice by providing dermatologists with an outline of the laser options available to them in the treatment of various types of pediatric vascular lesions, with spec
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