Vesiculobullous eruption from intense pulsed light treatment.
Dermatol Surg. 2005 Mar; 31(3): 345-8; discussion 348-9
Sperber BR, Walling HW, Arpey CJ, Whitaker DC

BACKGROUND: Intense pulsed light (IPL) systems emit non-coherent,
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.