Freckling 11 years after pulsed dye laser therapy for an infantile hemangioma: Coincidence or a previously unrecognized complication?

A case of asymmetric freckling on the cheeks of a child who 11 years earlier received pulsed dye laser treatment for a hemangioma on the right cheek was recently evaluated. Only the lasered areas of the face (her cheeks) demonstrated asymmetric freckling, whereas the unlasered areas of the face such as the nose demonstrated typical, normal, symmetric freckling. No explanation, such as asymmetric sun exposure or sunscreen administration, could be elicited by detailed history. The authors suggest that the asymmetric freckling on the patient's cheeks might represent a previously unrecognized complication of pulsed dye laser.