12.  Should you laser hemangiomas in infancy?  (PRS 1997; 99:1301)

Answer:
In a large retrospective study of 299 hemangiomas, management by observation was compared to laser therapy. The outcomes of each patient were evaluated based on improvement of volume, color, and texture. Treatment with laser is superior to observation in improving volume and texture. The mean treatment period for laser therapy was 2 years and 1 month while for the observation group it was 4 years and 9 months. The rate of complications with laser therapy was higher at 16% compared to 5% in the observation group. Complications included bleeding, infection, and scarring. The investigators also pointed out that the complications at first consultation was 46% for the observation group and 48% for the laser group. These complications included obstruction, ulceration, bleeding, infection, and pain. The authors primarily used the argon laser because of its ability to penetrate deeper lesions. Base on their data the authors concluded that there was an advantage to treating with lasers even with the higher complication rate because of the high rate of complications at first presentation. Laser therapy also minimizes psychological stress at school age.
 

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