O.15 Pulse dye LASER - treatments can be safely delivered without formal test patching in children

Published Date: 14th December 2022

Publication Authors: Naji S

Introduction
Pulse dye LASER (PDL) traditionally requires test patching prior to full treatment, to assess for efficacy and side effects. In our unit, in children under age 6, this requires a general anaesthetic. The aim of this study was to ascertain whether results of test patching change settings chosen for subsequent treatment and therefore, whether test patches are necessary.

Method
Retrospective review of 29 newly treated patients with Fitzpatrick skin types I-III, using Candela Vbeam Perfecta, from a prospectively populated database was performed. LASER settings and any side effects, of test patching and 1-3 subsequent treatments were analysed.

Results
An average of 1.8 treatment settings were used for test patching. Each patient’s test patch used the same pulse duration, spot size and cooling settings, with variance of fluence only. An average of 15.5 shots per test was performed. Only 2 patients had Treatment 1 fluences lower than the Test Patch, because of strong responses noted immediately. 45% of Treatment 1 fluences started with the same fluence as the test patch with the majority increased during Treatment 1. No side effects were noted in this cohort following any treatment.

Conclusion
For an experienced operator, full treatment without test patching can safely be performed in patients with Fitzpatrick skin type I-III, because immediate clinical assessment is sufficient. PDL treatment of entire lesions is now performed based upon immediate result of test shots and a prospective audit is ongoing. Benefits include reduced number of general anaesthetics, reduced waiting lists and better cost efficiency.

 

Naji, S; Jones, C; Breuning, E. (2022). O.15 Pulse dye LASER - treatments can be safely delivered without formal test patching in children. Lasers in Medical Science. 37(9), p.3774. [Online]. Available at: https://doi.org/10.1007/s10103-022-03623-y [Accessed 21 February 2023]

 

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