Skip to main content

Advertisement

SpringerLink
Log in

Treatment of the skin manifestations of hereditary hemorrhagic telangiectasia with pulsed dye laser

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Hereditary hemorrhagic telangiectasia (HHT) is a familial disorder, in which variably sized arteriovenous malformations develop in the skin, respiratory tract, central nervous system, and gastrointestinal and urogenital tracts. Bleeding is a major problem in the abnormal vessels, primarily in the nose and internal lesions. Skin lesions, in contrast, do not generally bleed spontaneously but pose a significant cosmetic concern. The lesions are characteristically small caliber vessels located in the dermis. As such, they are ideal targets for vascular lesions. Eight patients with cutaneous facial lesions of HHT were treated by pulsed dye laser. All patients exhibited excellent (75–100 %) clearance after a mean of 2.6 treatments (range 1–8). In comparison, a control group of patients with non-HHT facial telangiectasia required a mean of 1.9 (range 1–5; p < 0.05) treatments. No adverse events were reported in either group. The study confirms the safety and efficacy of PDL in the management of the cutaneous lesions of HHT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. McDonald J, Bayrak-Toydemir P, Pyeritz RE (2011) Hereditary hemorrhagic telangiectasia: an overview of diagnosis, management, and pathogenesis. Genet Med 13:607–616

    Article  PubMed  Google Scholar 

  2. Weber FP (1908) Multiple hereditary developmental angiomata with recurring epistaxis. Proc R Soc Med 1:65–66

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Lebrin F, Srun S, Raymond K, Martin S, van den Brink S, Freitas C et al (2010) Thalidomide stimulates vessel maturation and reduces epistaxis in individuals with hereditary hemorrhagic telangiectasia. Nat Med 16:420–428

    Article  CAS  PubMed  Google Scholar 

  4. Shovlin CL, Guttmacher AE, Buscarini E, Faughnan ME, Hyland RH, Westermann CJ et al (2000) Diagnostic criteria for hereditary hemorrhagic telangiectasia (Rendu–Osler–Weber syndrome). Am J Med Genet 91:66–67

    Article  CAS  PubMed  Google Scholar 

  5. Ben-Bassat M, Kaplan I, Levy R (1978) Treatment of hereditary hemorrhagic telangiectasia of the nasal mucosa with the carbon dioxide laser. Br J Plast Surg 31:157–158

    Article  CAS  PubMed  Google Scholar 

  6. Ghaheri BA, Fong KJ, Hwang PH (2006) The utility of bipolar electrocautery in hereditary hemorrhagic telangiectasia. Otolaryngol Head Neck Surg 134:1006–1009

    Article  PubMed  Google Scholar 

  7. Illum P, Bjerring P (1988) Hereditary hemorrhagic telangiectasia treated by laser surgery. Rhinology 26:19–24

    CAS  PubMed  Google Scholar 

  8. Ishibashi T, Takamatsu S (2003) Hereditary hemorrhagic telangiectasis treated by the harmonic scalpel. Head Neck 25:333–336

    Article  PubMed  Google Scholar 

  9. Joshi H, Woodworth BA, Carney AS (2011) Coblation for epistaxis management in patients with hereditary hemorrhagic telangiectasia: a multicentre case series. J Laryngol Otol 125:1176–1180

    Article  CAS  PubMed  Google Scholar 

  10. Kluger PB, Shapshay SM, Hybels RL, Bohigian RK (1987) Neodymium-YAG laser intranasal photocoagulation in hereditary hemorrhagic telangiectasia: an update report. Laryngoscope 97:1397–1401

    Article  CAS  PubMed  Google Scholar 

  11. Lyons GD, Owens RE, Mouney DF (1981) Argon laser destruction of cutaneous telangiectatic lesions. Laryngoscope 91:1322–1325

    Article  CAS  PubMed  Google Scholar 

  12. McCaughan JS Jr, Hawley PC, LaRosa JC, Thomas JH, Hicks WJ (1996) Photodynamic therapy to control life-threatening hemorrhage from hereditary hemorrhagic telangiectasia. Lasers Surg Med 19:492–494

    Article  PubMed  Google Scholar 

  13. Niyazi M, Caversaccio MD, Dubach P, Geretschlager A, Arnold A, Belka C et al (2010) Intensity-modulated radiotherapy for a Rendu–Osler–Weber disease patient with recurrent severe epistaxis: a case report. Case Report Med 2010:321835

    Google Scholar 

  14. Richmon JD, Tian Y, Husseman J, Davidson TM (2007) Use of a sprayed fibrin hemostatic sealant after laser therapy for hereditary hemorrhagic telangiectasia epistaxis. Am J Rhinol 21:187–191

    Article  PubMed  Google Scholar 

  15. Sadick H, Naim R, Oulmi J, Hormann K, Bergler W (2003) Plasma surgery and topical estriol: effects on the nasal mucosa and long-term results in patients with Osler’s disease. Otolaryngol Head Neck Surg 129:233–238

    Article  PubMed  Google Scholar 

  16. Simonds J, Miller F, Mandel J, Davidson TM (2009) The effect of bevacizumab (Avastin) treatment on epistaxis in hereditary hemorrhagic telangiectasia. Laryngoscope 119:988–992

    Article  CAS  PubMed  Google Scholar 

  17. Van Cutsem E, Rutgeerts P, Geboes K, Van Gompel F, Vantrappen G (1988) Estrogen–progesterone treatment of Osler–Weber–Rendu disease. J Clin Gastroenterol 10:676–679

    Article  PubMed  Google Scholar 

  18. Vickery CL, Kuhn FA (1996) Using the KTP/532 laser to control epistaxis in patients with hereditary hemorrhagic telangiectasia. South Med J 89:78–80

    Article  CAS  PubMed  Google Scholar 

  19. Weissman JL, Jungreis CA, Johnson JT (1995) Therapeutic embolization for control of epistaxis in a patient with hereditary hemorrhagic telangiectasia. Am J Otolaryngol 16:138–140

    Article  CAS  PubMed  Google Scholar 

  20. Werner A, Baumler W, Zietz S, Kuhnel T, Hohenleutner U, Landthaler M (2008) Hereditary hemorrhagic telangiectasia treated by pulsed neodymium:yttrium–aluminum–garnet (Nd:YAG) laser (1,064 nm). Lasers Med Sci 23:385–391

    Article  CAS  PubMed  Google Scholar 

  21. Fernandez-Jorge B, Del Pozo Losada J, Paradela S, Martinez-Gonzalez C, Fonseca E (2007) Treatment of cutaneous and mucosal telangiectases in hereditary hemorrhagic telangiectasia: report of three cases. J Cosmet Laser Ther 9:29–33

    Article  PubMed  Google Scholar 

  22. Dave RU, Mahaffey PJ, Monk BE (2000) Cutaneous lesions in hereditary hemorrhagic telangiectasia: successful treatment with the tunable dye laser. J Cutan Laser Ther 2:191–193

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Herzelia Dermatology and Laser Center, Herzelia Pituach, Israel

    Shlomit Halachmi

  2. Department of Plastic Surgery, Sheba Medical Center, Ramat Gan, Israel

    Hadar Israeli

  3. Pediatric Dermatology Unit, Schneider Children’s Medical Center, Petach Tikva, Israel

    Dan Ben-Amitai

  4. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Dan Ben-Amitai & Moshe Lapidoth

  5. Laser Unit, Department of Dermatology, Rabin Medical Center, 7 Keren Kayemet St., Petach Tikva, Israel

    Moshe Lapidoth

Authors
  1. Shlomit Halachmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hadar Israeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dan Ben-Amitai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Moshe Lapidoth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Moshe Lapidoth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Halachmi, S., Israeli, H., Ben-Amitai, D. et al. Treatment of the skin manifestations of hereditary hemorrhagic telangiectasia with pulsed dye laser. Lasers Med Sci 29, 321–324 (2014). https://doi.org/10.1007/s10103-013-1346-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-013-1346-x

Keywords

Search

Navigation