Leg ulceration after pulsed dye laser treatment of a vascular malformation.
BACKGROUND AND OBJECTIVES: The pulse dye laser (PDL) is a well-established treatment for port wine stains (PWSs) and is generally accepted to be safe, effective, and results in fading in the majority of patients. Significant side effects such as scarring are extremely rare. To date ulceration has not been reported. STUDY DESIGN/PATIENTS AND METHODS: We report a 22-year-old male who presented with a large vascular malformation on his lower leg with both superficial capillary and deeper venous components, which on venography and ultrasound showed abnormal architecture and reflux into the superficial collecting system. He underwent a series of test areas with the PDL on the lower leg. RESULTS: Ulceration developed in multiple sites after treatment as well as significant symptoms and signs of varicose eczema, which took at least 2 months to heal despite appropriate topical treatments and compression. CONCLUSIONS: Patients with vascular malformations of the lower leg with deeper venous components should be warned about the development of ulceration and treated with caution.