Treatment of xanthelasma palpebrarum using a pulsed dye laser: a prospective clinical trial in 38 cases.

BACKGROUND Several studies have reported positive results of nonablative laser treatment of xanthelasma palpebrarum, but the published evidence is weak and inconclusive. OBJECTIVE To systematically evaluate the effect of pulsed dye laser (PDL) treatment of xanthelasmas. MATERIALS AND METHODS Twenty female Caucasian patients with 38 lesions (< or =1 mm above skin level) were enrolled. They received up to five treatment sessions with a PDL (wavelength, 585 nm; energy fluence, 7 J/cm(2); pulse duration, 0.5 ms; spot size, 10 mm; number of passes, 2) at 2- to 3-week intervals. Photographs were taken before each treatment session and 4 weeks after the last treatment. Two independent examiners categorized clearance into four groups (no clearance [<25% xanthelasma area(s) cleared], moderate [25-50%], good [51-75%], and excellent [>75%]). Patient satisfaction was assessed on a verbal rating scale. RESULTS Approximately two-thirds of the lesions showed clearance greater than 50%, and one-quarter had clearance greater than 75%. Interrater reliability was excellent (contingency coefficient >0.7 at all visits). Treatments were well tolerated and had no major side effects. Patient satisfaction was generally high. CONCLUSION PDL is a promising approach for treating xanthelasmas, especially when multiple sessions are performed.