Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review
Abstract Port‐wine stains (PWS) are capillary vascular anomalies that are often treated with pulsed‐dye laser (PDL). Revascularization limits persistent clearance; however, the anti‐angiogenic effects of sirolimus (SIRO) may inhibit revascularization. This review aims to determine differences in PWS...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Skin Health and Disease |
| Online Access: | https://doi.org/10.1002/ski2.333 |
| _version_ | 1797336244889321472 |
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| author | Isabella J. Tan Thu M. Truong Gaurav N. Pathak Shaunt Mehdikhani Babar Rao Bernard A. Cohen |
| author_facet | Isabella J. Tan Thu M. Truong Gaurav N. Pathak Shaunt Mehdikhani Babar Rao Bernard A. Cohen |
| author_sort | Isabella J. Tan |
| collection | DOAJ |
| description | Abstract Port‐wine stains (PWS) are capillary vascular anomalies that are often treated with pulsed‐dye laser (PDL). Revascularization limits persistent clearance; however, the anti‐angiogenic effects of sirolimus (SIRO) may inhibit revascularization. This review aims to determine differences in PWS outcomes when treated with PDL monotherapy or in combination with SIRO. A systematic review was conducted using PubMed, Cochrane, and Embase databases. The following search terms were used: ‘port wine stain PDL SIRO’, ‘port wine stain PDL’, and ‘port wine stain PDL and topical treatment’ with (MeSH) and (Title/Abstract) limits. The search was limited to the English language and human‐subject studies conducted between 1 January 2000 and 1 June 2023. Inclusion criteria included studies evaluating SIRO as an adjunct to PDL in patients with PWS. Data extraction and quality assessment were performed by two independent reviewers. A total of nine studies met the inclusion criteria, which included randomized controlled trials (3), case series (2), case reports (3), and a prospective intrapatient study (1), which represented a total of 58 patients. Five studies showed improvement of a measured post‐treatment PDL parameter including shortening treatment time and less frequent dosing. A subset of studies (4/9) which did not demonstrate significant clinical improvements exhibited significant photographic evidence of improvement. Heterogeneity among the studies highlights the need for further research and standardization. While adjunctive SIRO shows promise, larger studies and comprehensive evaluation methods are required to establish conclusive safety and efficacy guidelines to shape clinical decision‐making. |
| first_indexed | 2024-03-08T08:51:27Z |
| format | Article |
| id | doaj.art-93236ce6dbfc4ba0a578bd100e0b0549 |
| institution | Directory Open Access Journal |
| issn | 2690-442X |
| language | English |
| last_indexed | 2024-03-08T08:51:27Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Skin Health and Disease |
| spelling | doaj.art-93236ce6dbfc4ba0a578bd100e0b05492024-02-01T09:32:21ZengWileySkin Health and Disease2690-442X2024-02-0141n/an/a10.1002/ski2.333Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic reviewIsabella J. Tan0Thu M. Truong1Gaurav N. Pathak2Shaunt Mehdikhani3Babar Rao4Bernard A. Cohen5Robert Wood Johnson Medical School, Rutgers The State University of New Jersey Piscataway New Jersey USARobert Wood Johnson Medical School, Rutgers The State University of New Jersey Piscataway New Jersey USARobert Wood Johnson Medical School, Rutgers The State University of New Jersey Piscataway New Jersey USARobert Wood Johnson Medical School, Rutgers The State University of New Jersey Piscataway New Jersey USARobert Wood Johnson Medical School, Rutgers The State University of New Jersey Piscataway New Jersey USADepartment of Dermatology The Johns Hopkins Hospital Baltimore Maryland USAAbstract Port‐wine stains (PWS) are capillary vascular anomalies that are often treated with pulsed‐dye laser (PDL). Revascularization limits persistent clearance; however, the anti‐angiogenic effects of sirolimus (SIRO) may inhibit revascularization. This review aims to determine differences in PWS outcomes when treated with PDL monotherapy or in combination with SIRO. A systematic review was conducted using PubMed, Cochrane, and Embase databases. The following search terms were used: ‘port wine stain PDL SIRO’, ‘port wine stain PDL’, and ‘port wine stain PDL and topical treatment’ with (MeSH) and (Title/Abstract) limits. The search was limited to the English language and human‐subject studies conducted between 1 January 2000 and 1 June 2023. Inclusion criteria included studies evaluating SIRO as an adjunct to PDL in patients with PWS. Data extraction and quality assessment were performed by two independent reviewers. A total of nine studies met the inclusion criteria, which included randomized controlled trials (3), case series (2), case reports (3), and a prospective intrapatient study (1), which represented a total of 58 patients. Five studies showed improvement of a measured post‐treatment PDL parameter including shortening treatment time and less frequent dosing. A subset of studies (4/9) which did not demonstrate significant clinical improvements exhibited significant photographic evidence of improvement. Heterogeneity among the studies highlights the need for further research and standardization. While adjunctive SIRO shows promise, larger studies and comprehensive evaluation methods are required to establish conclusive safety and efficacy guidelines to shape clinical decision‐making.https://doi.org/10.1002/ski2.333 |
| spellingShingle | Isabella J. Tan Thu M. Truong Gaurav N. Pathak Shaunt Mehdikhani Babar Rao Bernard A. Cohen Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review Skin Health and Disease |
| title | Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review |
| title_full | Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review |
| title_fullStr | Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review |
| title_full_unstemmed | Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review |
| title_short | Evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations: A systematic review |
| title_sort | evaluating the clinical efficacy of pulsed dye laser with sirolimus for treatment of capillary malformations a systematic review |
| url | https://doi.org/10.1002/ski2.333 |
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