After 5 treatments with the pulsed dye laser the vascular malformation had almost completely resolved. PWS's respond well to pulsed dye laser therapy. In infants even large areas can be treated in several minutes. Pain associated with laser therapy can usually be managed with aggressive topical anesthesia. Patients require multiple treatments of the entire lesion every 2 to 3 months until the lesion clears or no further improvement is noted.
Pyogenic granulomas are benign vascular tumors comprised of capillaries and connective tissue.
They appear as o.5 to 1.0 centimeter hemorrhagic mushroom-shaped papules and nodules on the skin surface. When traumatized they bleed profusely prompting visits to the emergency room for cautery. Unless the base of the lesion is destroyed, pyogenic granulomas tend to recur and rebleed. PG's occur most frequently in infants, toddlers, and school-age children. The face and hands are the most common sites of involvement followed by the scalp, neck, trunk, and extremities.