Vesiculobullous Eruption from Intense Pulsed Light Treatment

• Published in: Dermatologic surgery 2005-03, Vol.31 (3), p.345-349
• Main Authors: Sperber, Brian R., Walling, Hobart W., Arpey, Christopher J., Whitaker, Duane C.
• Format: Article
• Language: English
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2005.31085

Background Intense pulsed light (IPL) systems emit noncoherent, polychromatic light and are increasingly used for various dermatologic indications. Although generally regarded as safe therapy, IPL is not without risk. Objective We report a 21‐year‐old woman who experienced a severe blistering eruption after IPL treatment by a nonphysician. Materials and Methods Case report. Results The patient reported a 10‐year history of persistent redness on her medial and lateral cheeks. She had tried no previous oral or topical therapies. She was diagnosed with rosacea and was treated with IPL. The following day, intense vesiculation and bullae formation occurred, progressing to dramatic facial edema by day 3 and eschar formation by day 5. Ten weeks later, prominent erythema with papularity remained on both cheeks and the lateral neck, with textural change and reticulated dyschromia. She continued to recover 20 weeks after treatment. Conclusion This case most likely represents high‐fluence photothermal tissue injury induced by the laser‐like qualities of the IPL source, with resulting acantholysis leading to formation of vesicobullae in the context of an uncertain primary diagnosis. This case highlights the potential hazards of IPL therapy and raises questions regarding appropriate use of this medical technology. BRIAN R. SPERBER, MD, PhD, HOBART W. WALLING, MD, PhD, CHRISTOPHER J. ARPEY, MD, AND DUANE C. WHITAKER, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.