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The American Journal of Dermatopathology Jul 2012Cutaneous arteriovenous malformations (AVMs) of stage I may mimic port-wine stains (PWSs) clinicopathologically; therefore, it may be misdiagnosed and mistreated as...
BACKGROUND
Cutaneous arteriovenous malformations (AVMs) of stage I may mimic port-wine stains (PWSs) clinicopathologically; therefore, it may be misdiagnosed and mistreated as being PWS.
OBJECTIVE
To suggest the clinicopathological differential clues between early AVMs and PWSs.
METHODS
A set of 10 radiologically proven AVMs of stage I was selected in conjunction with a set of 10 age-/sex-matched PWSs as a control. Their clinical features, hematoxylin and eosin, CD31, and smooth muscle actin immunohistochemistry were then compared.
RESULTS
Four pathological clues for differential diagnosis with statistical significance (P < 0.05) were found: the vessel density (CD31), presence of vascular luminal red blood cells, elongation and haphazard branching of vessels, and thickened vessel walls highlighted by smooth muscle actin.
CONCLUSION
Therefore, 4 differential clues with respect to stage I AVM and PWS in their earlier developmental stages have been proposed.
Topics: Actins; Adolescent; Adult; Arteriovenous Malformations; Biomarkers; Biopsy; Blood Vessels; Case-Control Studies; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Infant; Male; Platelet Endothelial Cell Adhesion Molecule-1; Port-Wine Stain; Predictive Value of Tests; Republic of Korea; Skin; Young Adult
PubMed: 21814130
DOI: 10.1097/DAD.0b013e3181b76443 -
Journal of Cosmetic and Laser Therapy :... Nov 2021Noninvasive pulsed dye laser is the current gold standard for the treatment of port wine stains. However, most port wine stains are not completely cleared after pulsed... (Review)
Review
Noninvasive pulsed dye laser is the current gold standard for the treatment of port wine stains. However, most port wine stains are not completely cleared after pulsed dye laser therapy, owing to insufficient photocoagulation and laser-induced vascular regeneration and reperfusion. Several studies have explored approaches designed to improve treatment efficacy. This integrative literature review summarizes the results of clinical and animal studies published between 2004 and 2021. Pulsed dye laser has been administered in combination with photoelectric devices (the neodymium: yttrium-aluminum-garnet lasers, dual-wavelength 1064-/595-nm laser irradiation, fiberoptic Nd-YAG laser, photodynamic therapy, and radio frequency), and drugs (rapamycin, imiquimod, timolol, axitinib, endothelin receptor antagonist, artificial red blood cells and oxymetazoline). The initial results suggest that combination therapy is a direction worth exploring in the future. Further large prospective, blinded and controlled multicenter clinical trials with longer follow-up period are required to obtain more robust evidence.
Topics: Animals; Laser Therapy; Lasers, Dye; Lasers, Solid-State; Multicenter Studies as Topic; Phototherapy; Port-Wine Stain; Prospective Studies; Treatment Outcome
PubMed: 35422188
DOI: 10.1080/14764172.2022.2052901 -
Dermatologic Surgery : Official... Apr 2021Although pulsed-dye laser (PDL) 595 nm is known as the gold standard for treatment of port-wine stains (PWS), complete clearance of lesions occurs in a minority of cases.
BACKGROUND
Although pulsed-dye laser (PDL) 595 nm is known as the gold standard for treatment of port-wine stains (PWS), complete clearance of lesions occurs in a minority of cases.
OBJECTIVE
To compare the efficacy and safety of double-pass pulsed-dye laser (DPL), long pulse duration (20 m/s) followed by short pulse duration (1.5 m/s) within 20 minutes interval, with single-pass pulsed-dye laser (SPL) for (1.5 m/s) in the treatment of PWS.
METHODS
Twenty-four patients with PWS underwent 3 sessions of PDL. Each lesion was randomly divided into 2 portions to receive DPL or SPL. Colorimetric and dermoscopic evaluations were used to determine the response objectively. In addition, improvement was scored subjectively using the visual analog scale (VAS).
RESULTS
According to colorimetric analysis, the mean blanching rates for DPL and SPL treated sites were 48% (SD = 0.215) and 37% (SD = 0.213), respectively (p = .001). With VAS, 3.79 (SD = 0.93) and 3.33 (SD = 0.91) improvement scores were reported in the DPL and SPL treated areas, respectively (p = .008). Dermoscopic images showed that larger deep vessels were the most common remnant vessels in both treatment areas.
CONCLUSION
Compared with SPL, DPL with 20 minutes interval seems to be a more effective and safe method for the treatment of PWS.
Topics: Adolescent; Adult; Child; Double-Blind Method; Female; Follow-Up Studies; Humans; Laser Therapy; Lasers, Dye; Male; Middle Aged; Port-Wine Stain; Retrospective Studies; Time Factors; Treatment Outcome; Young Adult
PubMed: 33795569
DOI: 10.1097/DSS.0000000000002819 -
Lasers in Medical Science Nov 2011Port-wine stains (PWS) are congenital, progressive vascular malformations of the dermis that are often disfiguring, particularly when located in a cosmetically relevant... (Review)
Review
Port-wine stains (PWS) are congenital, progressive vascular malformations of the dermis that are often disfiguring, particularly when located in a cosmetically relevant area. Thus, the successful clearance of PWS is of highest medical relevance, and laser therapy is the treatment of choice for this indication. Numerous trials have shown the effectiveness of both lasers and incoherent light sources. Laser or IPL treatments achieve good clearance in the majority of PWS, but complete clearance is rare. Thus, new therapeutic options are urgently required. Photodynamic therapy is a relatively new approach in the treatment of PWS. Our review aims to summarize therapy options of port-wine stains, depending on treatment area, patient age, and vessel architecture. Recent developments in this field and new insights into the pathogenesis of PWS are discussed. The review also highlights practical aspects, complications that can occur, and how to prevent them.
Topics: Humans; Low-Level Light Therapy; Photochemotherapy; Phototherapy; Port-Wine Stain; Recurrence; Treatment Outcome
PubMed: 21390514
DOI: 10.1007/s10103-011-0903-4 -
Annales de Dermatologie Et de... Mar 2013
Review
Topics: Administration, Cutaneous; Angiogenesis Inhibitors; Cicatrix; Clinical Trials as Topic; Hemoglobins; Humans; Hypertonic Solutions; Hypothermia, Induced; Indocyanine Green; Laser Therapy; Lasers; Melanins; Photochemistry; Photochemotherapy; Port-Wine Stain; Postoperative Complications; Radiation-Sensitizing Agents; Risk; Secondary Prevention
PubMed: 23466161
DOI: 10.1016/j.annder.2012.12.015 -
Ophthalmic Plastic and Reconstructive... 2008A 69-year-old white man with a medical history of left-sided cluster headaches presented for evaluation of dermatochalasis. The left upper eyelid demonstrated red-pink,...
A 69-year-old white man with a medical history of left-sided cluster headaches presented for evaluation of dermatochalasis. The left upper eyelid demonstrated red-pink, blanchable macules that coalesced in a patch. The lesion appeared after an episode of a cluster headache. Upper eyelid blepharoplasty permitted en bloc removal of most of the lesion. Histopathologic evaluation demonstrated aggregates of telangiectatic blood vessels in the papillary dermis consistent with the diagnosis of an acquired port wine stain. The authors report, to their knowledge, the first description of an acquired port wine stain associated with cluster headaches.
Topics: Aged; Blepharoplasty; Cluster Headache; Diagnosis, Differential; Eyelids; Follow-Up Studies; Humans; Male; Port-Wine Stain
PubMed: 19033853
DOI: 10.1097/IOP.0b013e31818d1dd7 -
Cutis Dec 2015Port-wine stains (PWSs), or capillary malformations, are common congenital lesions, but acquired lesions rarely present in the setting of trauma. We present the case of...
Port-wine stains (PWSs), or capillary malformations, are common congenital lesions, but acquired lesions rarely present in the setting of trauma. We present the case of an 18-year-old man who developed a PWS and associated localized eczema following penetrating trauma to the left abdomen. The diagnoses were confirmed on biopsy. The patient's eczema improved with topical steroids. Magnetic resonance imaging of PWSs is recommended in order to rule out deeper arteriovenous malformations. More research is needed to elucidate the connection between PWS pathophysiology and the development of eczema.
Topics: Abdominal Injuries; Administration, Cutaneous; Adolescent; Anti-Inflammatory Agents; Diagnosis, Differential; Eczema; Humans; Male; Port-Wine Stain; Triamcinolone; Wounds, Stab
PubMed: 26761933
DOI: No ID Found -
Clinical and Experimental Dermatology Aug 2011Acquired port-wine stains (PWSs) are rare but well recognized, and have often been reported in association with localized trauma. Various drugs have also been implicated...
Acquired port-wine stains (PWSs) are rare but well recognized, and have often been reported in association with localized trauma. Various drugs have also been implicated as aetiological factors. We report the case of a 71-year-old man with an extensive congenital PWS affecting the left side of the face, upper chest and upper back. At the age of 69 years, he began to develop similar areas on his right hand and forearm, left hand and left knee. This corresponded temporally to being started on simvastatin and metformin, both of which may promote angiogenesis.
Topics: Aged; Anticholesteremic Agents; Biopsy; Diagnosis, Differential; Humans; Hypoglycemic Agents; Male; Port-Wine Stain
PubMed: 21771006
DOI: 10.1111/j.1365-2230.2010.04004.x -
Indian Journal of Dermatology,... 2023Port-wine stains are defined as congenital benign vascular lesions. The treatment of port-wine stains remains a challenge, worldwide. This study aimed to analyze the...
BACKGROUND AND OBJECTIVES
Port-wine stains are defined as congenital benign vascular lesions. The treatment of port-wine stains remains a challenge, worldwide. This study aimed to analyze the histological characteristics in different types of port-wine stains and provide guidance for clinical decision-making.
METHODS AND MATERIALS
Biopsies were from the hospital from 2015 to 2021. H&E staining, Immunofluorescence staining, Masson's trichrome staining and Weigert staining were performed on the tissues.
RESULTS
A total of 35 port-wine stains patients were included in the study of four distinct types, namely red port-wine stains (11 cases), purple port-wine stains (seven cases), hypertrophic port-wine stains (nine cases) and nodular port-wine stains (eight cases). The mean vessel diameter of the different types was 38.7 ± 5.9 μm, 93.5 ± 9.7 μm, 155.6 ± 21.8 μm and 155.6 ± 29.54 μm, respectively. Mean vessel depth was 396.4 ± 31 μm, 944.2 ± 105.4 μm, 2,971 ± 161.3 μm and 3,594 ± 364.6 μm, respectively. The vessels in red port-wine stains, purple port-wine stains and hypertrophic port-wine stains were mainly composed of capillary and venous malformations, whereas those in nodular port-wine stains were venous or arteriovenous malformations.
LIMITATION
The main limitation of the current study was the small number of patients.
CONCLUSION
As the disease progresses, vessel diameters become larger, the vessel wall becomes thicker and vessels were found in a greater depth. A treatment plan should be scientifically formulated keeping in mind the histological characteristics of port-wine stains.
Topics: Humans; Port-Wine Stain; Retrospective Studies; Capillaries; Arteriovenous Malformations; Vascular Malformations
PubMed: 35593279
DOI: 10.25259/IJDVL_730_2021 -
The British Journal of Dermatology May 2013Port-wine stains (PWS) are among the most common congenital vascular malformations. Unlike capillary haemangiomas, these lesions do not involute spontaneously but rather... (Review)
Review
Port-wine stains (PWS) are among the most common congenital vascular malformations. Unlike capillary haemangiomas, these lesions do not involute spontaneously but rather become progressively more disfiguring as the patient ages. While benign in nature, the cosmetic deformity and attendant psychological and emotional distress prompt the majority of those afflicted to seek treatment. The pulsed dye laser (PDL) has long been considered the treatment of choice for these vascular lesions; however, very few patients achieve total clearance with PDL therapy and a significant number of lesions fail to respond at all. In order to address these recalcitrant cases, the mechanisms that contribute to treatment resistance must be understood and novel laser and light therapies must be employed. This review will address what is currently known about lesion-specific characteristics of PDL-resistant PWS as well as discuss current and future treatment options.
Topics: Age Factors; Angiogenesis Inhibitors; Humans; Lasers, Dye; Lasers, Solid-State; Low-Level Light Therapy; Port-Wine Stain; Time Factors; Treatment Outcome
PubMed: 23290045
DOI: 10.1111/bjd.12204