RESUMO
BACKGROUND: Data on the benefits, adverse effects and appropriate types of laser treatment for angiofibromas (AF) in patients with tuberous sclerosis (TS) are limited. OBJECTIVES: To evaluate the efficacy and side-effect profile of carbon dioxide (CO2) 10,600 nm wavelength and flashlamp-pumped pulsed dye (FLPDL) 585 nm wavelength lasers in a retrospective study of 29 patients with TS aged 9-48 years. METHODS: Long-term results, based on clinical improvement of the vascular, fibrous or protuberant types of AF and the presence or absence of side-effects on follow-up visits, were classified as excellent, moderate or poor. RESULTS: Results were excellent in most patients with vascular-type AF treated with one or two sessions of FLPDL, but some required up to six treatment sessions. CO2 lasers produced excellent results with considerable long-term improvement in 10 of 13 (77%) patients with fibrous or protuberant AF, specifically in all (three of three) protuberant and 70% (seven of 10) of fibrous AF. Persistent hypertrophic scarring was seen in three of 13 (23%) patients with either fibrous or protuberant AF treated with the continuous wavelength CO2 laser. Treatment with both lasers used in four patients with combined vascular and non-vascular AF components was excellent in three of four (75%) patients. Significant relapse was seen in one patient treated with the CO2 laser. CONCLUSIONS: CO2 or FLPDL laser treatment should be considered as an effective treatment for patients with disfiguring TS. A combination of lasers may be required to achieve optimal results.