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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-29022024-112809
Document
Author
Full name
Ludmilla Cardoso Gomes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Torezan, Luís Antonio Ribeiro (President)
Reis, Vitor Manoel Silva dos
Rocha, Lílian Kelly Faria Licarião
Samorano, Luciana de Paula
Title in Portuguese
Avaliação do tratamento de malformações vasculares cutâneas capilares e venosas com uso do laser Nd:YAG de pulso longo 1064 nm e da luz intensa pulsada
Keywords in Portuguese
Anomalias vasculares
Malformação vascular venosa
Malformações vasculares
Mancha vinho do Porto
Terapia a laser
Terapia de luz pulsada intensa
Abstract in Portuguese
As malformações vasculares cutâneas são lesões caracterizadas por ectasia nos vasos que tendem a progredir em extensão e em espessura, sem regressão espontânea. Sua localização predominante na face e no pescoço oferece prejuízo estético e psicológico para os portadores, sendo o seu tratamento indicado precocemente na infância. Realizou-se estudo retrospectivo, a fim de avaliar a resposta do uso da luz intensa pulsada (LIP) e do laser de Nd:YAG (Neodímio:Ítrio- Alumínio-Granada) 1064 nm de pulso longo associado ou não à LIP no tratamento de malformações vasculares capilares e venosas em pacientes atendidos entre setembro de 2013 e fevereiro de 2019 no serviço de dermatologia de um hospital terciário. Foram avaliados 30 pacientes com média de idade de 38,4 anos. A análise fotográfica qualitativa mostrou clareamento maior que 50% em 27,8% dos pacientes tratados apenas com LIP e em 66,6% dos tratados com laser Nd:YAG 1064 nm associado ou não à LIP (p = 0,196). A avaliação pelos pacientes mostrou alto grau de satisfação à terapia em 83,3% e 55,6% dos pacientes tratados com o laser Nd:YAG associado ou não à LIP e apenas com LIP, respectivamente (p = 0,235). Em sete pacientes (23%) foram observadas complicações, das quais 4 (57%) foram transitórias (hipo e hiperpigmentação) e 3 (43%), permanentes (2 cicatrizes atróficas e 1 hipertrófica), mas não foi observada associação estatística entre a duração das complicações e o tratamento realizado. Concluímos que o laser Nd:YAG 1064 nm e a LIP mostraram ser métodos seguros e eficazes no tratamento de malformações vasculares cutâneas capilares e venosas. No entanto, não houve associação estatisticamente significante entre a avaliação antes e após o tratamento, nesta amostra estudada
Title in English
Evaluation of the treatment of capillary and venous cutaneous vascular malformations using neodymium:yttrium-aluminum-garnet 1064 nm long-pulse and intense pulsed light
Keywords in English
Intense pulsed light therapy
Laser therapy
Port-wine stain
Vascular anomalies
Vascular malformations
Venous vascular malformation
Abstract in English
Cutaneous vascular malformations are lesions characterized by ectasia in the vessels, that tend to progress in length and thickness, without spontaneous regression. A retrospective study was carried out in order to evaluate the response to the use of intense pulsed light (IPL) and Nd:YAG laser (Neodymium:Yttrium-Aluminium-Garnet) 1064 nm long pulse associated or not with IPL in the treatment of capillary and venous vascular malformations, based on photographic analysis of patients treated between september 2013 and february 2019 at the dermatology service of a tertiary hospital. We evaluated 30 patients, mean age was 38.4 years. We found improvement greater than 50% in 27.8% of patients treated just with IPL and in 66.6% of those treated with Nd:YAG laser in combination or not of IPL (p = 0.196). The evaluation by the patients showed a high degree of satisfaction with the therapy performed by 83.3% and 55.6% of patients treated with Nd:YAG laser associated or not with IPL and IPL alone, respectively (p = 0.235). Complications were observed in seven patients (23%), most of which 4 (57%) were temporary (hypo and hyperpigmentation) and 3 (43%) permanent (2 atrophic scars and 1 hypertrophic scar), but statistical association was not observed between the duration of complications and the treatment performed. We conclude that the 1064 nm Nd:YAG laser and IPL proved to be safe and effective methods in the treatment of capillary and venous cutaneous vascular malformations. However, there was no statistically significant association between the assessment before and after treatment in this sample studied
 
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Publishing Date
2024-03-04
 
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