الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cutaneous vascular lesions are categorized according to age of onset into two groups: congenital and acquired vascular lesions. Congenital lesions begin in infancy and include hemangiomas, Capillary malformation, Venous malformation, Arterial malformation, arteriovenous malformation and Lymphatic malformation . Congenital lesions are found most commonly on the head or neck and may be isolated or found as part of a congenital syndrome such as Sturge Weber syndrome. Acquired vascular lesions develop in persons of any age and include Telangiectases, Spider angioma, Cherry angioma, Pyogenic granuloma ,Venous lake and Leg vein anomalies .
There are many options for treating vascular lesions as: just observation, cryotherapy, surgical treatment, pharmacotherapy, embolization, photodynamic therapy, sclerotherapy and laser .
Since the introduction of laser for treatment of congenital and acquired vascular lesions, primary surgical therapy has gradually lost importance.
There is no single laser system, that can be successfully used for the treatment of every kind of cutaneous vascular lesions. The ideal laser for the treatment of cutaneous vascular lesions should have an appropriate wavelength (i.e. targeting the intravascular oxyhemoglobin), suitable pulse duration (to minimize damage to the surrounding healthy tissue) and a suitable energy setting .
Flashlamp-Pumped Pulsed Dye Laser, Long-Pulse Neodymium: Yttrium-Aluminum-Garnet Laser,Potassium Titanyl Phosphate Laser, Long-Pulse Alexandrite Laser and Diode Laser all can effectively treat congenital and acquired cutaneous vascular lesions. PDL has become the
criterion standard of treatment because of its superior clinical efficacy and low complication rate. However, patients with darker skin types who desire treatment should be properly informed of the potential pigmentation changes and other adverse effects that can occur after PDL treatment.
Particularly hemangiomas, but also venous malformations and lymphangiomas, are primarily treated by different types of lasers. Especially the Nd: YAG laser that often leads to satisfying results. It is primarily used for laser hair removal; however, Nd: YAG lasers, with their longer wavelengths and pulse durations, may be useful for deep and resistant vessels. The Nd: YAG laser can be used on patients with Fitzpatrick skin types IV to VI because there is much less melanin as a competing chromophore at this wavelength; however, care must be taken when using this laser due to higher incidence of scarring and blistering when compared with the PDL.
Cynergy multiplex laser is the first system to combine a long pulse pulsed dye-laser and a high powered Nd: YAG into one system. These wavelengths were chosen for their absorption characteristics and depth of penetration. Both wavelengths are well absorbed by blood. The wavelengths are synergistic in their depth of penetration criteria, the PDL has a more shallow depth of penetration while the Nd: YAG penetrates deeper.
The advantage of the KTP (532 nm) is that target vessels are not ruptured, leading to much less purpura. The disadvantage is that only patients with Fitzpatrick skin types I to III are candidates because there is significant melanin absorption at this wavelength. Patients with darker skin types will often have long-lasting dyspigmentation, blistering, or significant crusting .
Long-pulsed alexandrite lasers emit a wavelength of 755 nm. Although the main chromophore absorbed at this wavelength is melanin, hemoglobin also has a small but significant peak of absorption. The alexandrite penetrates to depths of 2 to 5 mm. These characteristics make this laser useful for various deeper and more resistant vascular lesions .
The diode laser is the most efficient light source. The smaller spot sizes of 2 to 14 mm allow for treatment of smaller telangiectasias. The 532 nm diode is advantageous for Fitzpatrick skin types I to III for reasons similar to the KTP laser .The longer-wavelength diode lasers are used for laser hair removal but can be useful for deeper vascular lesions.
Vascular lasers offer a minimally invasive therapeutic option for the treatment of a wide array of congenital and acquired vascular lesions. Such technology has dramatically changed the approach to the treatment of cutaneous vascular lesions.