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Lasers in Medical Science May 2010Reflectance spectrophotometry is the most established and widely used objective technique for the assessment of port-wine stain (PWS) skin, and has been applied... (Review)
Review
Reflectance spectrophotometry is the most established and widely used objective technique for the assessment of port-wine stain (PWS) skin, and has been applied extensively in other dermatological applications. To date, no review has been published regarding the different spectrophotometric devices used on PWS skin. This paper comprises such a review, introducing the reader to the relevant background material and then discussing scanning, narrow-band and tristimulus spectrophotometers in turn. Scanning spectrophotometry is the most versatile of the three methods but it is noted that considerable expertise is required to interpret the acquired data. Narrow-band and tristimulus devices are available at a much lower price and can be considerably simpler to use. They do, however, provide limited information that does not account for the complex effects of melanin and other chromophores within the skin. Although scanning spectrophotometers would be the preferred choice for most investigations, cheaper, simpler and equally reliable options are available and may better suit the needs of some research projects.
Topics: Colorimetry; Humans; Lasers, Dye; Low-Level Light Therapy; Models, Biological; Monte Carlo Method; Port-Wine Stain; Skin Pigmentation; Spectrophotometry
PubMed: 20087613
DOI: 10.1007/s10103-009-0726-8 -
Dermatologic Surgery : Official... Feb 1999Traditional mechanisms of assessing port-wine stain response to laser therapy have rested mainly on subjective determinations by physician and patient. However, the wide... (Comparative Study)
Comparative Study Review
BACKGROUND
Traditional mechanisms of assessing port-wine stain response to laser therapy have rested mainly on subjective determinations by physician and patient. However, the wide variation in treatment response poses a profound need for objective devices to measure treatment outcomes so that maximum effectiveness of therapy can be achieved without unnecessary repeat treatments.
OBJECTIVE
The purpose of this paper will be to review noninvasive techniques to measure port-wine stain response to laser therapy.
METHODS
This report is based on a review of medical and bioscience literature.
RESULTS
Several techniques including laser Doppler, reflectance spectrophotometry, tristimulus colorimetry, and videomicroscopy have been developed to address the need for objective measurement devices.
CONCLUSION
While many instruments are available, these techniques are limited by cost, small test size area, and/or inconclusive correlation with clinical response. A number of experimental techniques may circumvent many of the problems inherent in currently-available commercial technologies.
Topics: Diagnostic Imaging; Humans; Laser Therapy; Port-Wine Stain; Treatment Outcome
PubMed: 10037519
DOI: 10.1046/j.1524-4725.1999.08166.x -
Lasers in Surgery and Medicine Mar 2014Outcomes analysis of laser treatment for port-wine stains has been hampered by the lack of an objective measure of surface area and volume; moreover, treatment success...
BACKGROUND AND OBJECTIVE
Outcomes analysis of laser treatment for port-wine stains has been hampered by the lack of an objective measure of surface area and volume; moreover, treatment success is often gauged by clinician subjective assessment. Three-dimensional (3D) surface imaging has been applied in several medical disciplines to quantify surface changes, with promising results. We hypothesized that 3D surface imaging could be used to objectively measure changes in area and volume of port-wine stains following laser treatment.
STUDY DESIGN/MATERIALS AND METHODS
We performed a retrospective review of consecutive patients with port-wine stains treated over a 20-month time period. Area and volume of the lesions were measured using 3dMD photogrammetric software (3dMD, Atlanta, GA) before and after a series of sequential pulsed dye laser and/or alexandrite laser treatments.
RESULTS
Fifty-five patients with 59 port-wine stains were included in the study. The initial average measured area was 44.3 cm(2) ; final average measured area decreased to 36.9 cm(2) (P < 0.001). The average volume change was 1.20 cc for all PWS included in the study and 1.90 cc for lesions that received at least 5 laser treatments within the study period.
CONCLUSION
Three-dimensional photography demonstrated area and volume changes in patients with port-wine stains after laser treatments. Future studies to determine if statistically significant changes correlate with clinically appreciable changes are warranted.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Imaging, Three-Dimensional; Lasers, Dye; Lasers, Solid-State; Male; Middle Aged; Photography; Port-Wine Stain; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 24155123
DOI: 10.1002/lsm.22193 -
Actas Dermo-sifiliograficas Dec 2019
Topics: Aged, 80 and over; Carcinoma, Squamous Cell; Humans; Male; Port-Wine Stain; Skin Neoplasms
PubMed: 31202472
DOI: 10.1016/j.ad.2018.01.016 -
Annales de Dermatologie Et de... May 2013Port-wine stains or capillary malformations are generally congenital. Very few cases of acquired port-wine stains in adults have been described, and these occur... (Review)
Review
BACKGROUND
Port-wine stains or capillary malformations are generally congenital. Very few cases of acquired port-wine stains in adults have been described, and these occur particularly after trauma.
PATIENTS AND METHOD
We report three cases of acquired port-wine stains and we performed a review of the literature using the keywords "port-wine stain", "capillary malformation", "angioma" and "acquired" in the Medline database PubMed. All relevant articles were included.
RESULTS
Two male patients and one female patient consulted for one or more angiomatous lesions, located respectively on the upper rear part of the right thigh (case 1), the left leg (case 2) and the right side of the face, skull and chest (case 3). Each patient's skin biopsy was consistent with port-wine stain. The three patients asserted the acquired nature of the lesions: the male patients were respectively 17 and 38 years old, and the female patient was 11 years old. No causative factors were evident preceding the lesion, and there was no family history of port-wine stain. The topography was systematic in patients 2 and 3. The lesions were light red in patient 1, dark red in patient 2 and pale pink in patient 3. The remainder of the physical examination was unremarkable, except for benign angiokeratoma of the scrotum in case 1 and pigmented leucoderma-type macules in case 3. LITERATURE RESULTS: Sixty-six cases of acquired port-wine stains were reported in the literature. The average age was 25 years (3-69) with a sex-ratio of 0.88. Generally, no causative factor was given. However, trauma (30.5%), estrogenic impregnation (16.5%), and more rarely, medication, solar damage, frostbite, cluster headache, herpes zoster and acoustic neuroma were reported as causatives factors.
DISCUSSION
Acquired port-wine stain is rare. Although often idiopathic, it can result from spinal trauma, which must be explored if suggested by the history. In our series, the clinical presentation suggested a latent congenital vascular malformation of late onset, in particular in patients 2 and 3, because of the segmental distribution.
Topics: Adolescent; Adult; Age of Onset; Angiokeratoma; Biopsy; Diagnosis, Differential; Facial Dermatoses; Female; Hemangioma, Capillary; Humans; Male; Port-Wine Stain; Scrotum; Skin Neoplasms; Skin Pigmentation; Terminology as Topic; p120 GTPase Activating Protein
PubMed: 23663705
DOI: 10.1016/j.annder.2013.01.436 -
Pediatric Dermatology 2016Tufted angioma is an uncommon benign vascular tumor that typically is noted during infancy or childhood, with variable clinical presentation. We report the case of an...
Tufted angioma is an uncommon benign vascular tumor that typically is noted during infancy or childhood, with variable clinical presentation. We report the case of an infant with a tufted angioma initially presenting as a port-wine stain-like patch of the left cheek.
Topics: Diagnosis, Differential; Facial Dermatoses; Facial Neoplasms; Hemangioma; Humans; Infant, Newborn; Male; Port-Wine Stain; Skin Neoplasms
PubMed: 27001335
DOI: 10.1111/pde.12805 -
Lasers in Surgery and Medicine Dec 2019Port wine stain (PWS) is a congenital vascular malformation of the human skin. Laser is the treatment of choice for PWS. Laser-resistant PWS is one crucial factor...
BACKGROUND AND OBJECTIVES
Port wine stain (PWS) is a congenital vascular malformation of the human skin. Laser is the treatment of choice for PWS. Laser-resistant PWS is one crucial factor accounting for inadequate treatment outcome, which needs to be fully characterized. This study aims to quantitatively characterize the morphology of laser-resistant PWS blood vessels in the upper papillary dermis using in vivo reflectance confocal microscopy (RCM).
STUDY DESIGN/MATERIALS AND METHODS
A total of 42 PWS subjects receiving laser treatment from August 2016 through July 2018 were enrolled into this study. Thirty-three subjects had facial PWS; nine had extremity PWS. All subject's PWS received multiplex 585/1,064 nm laser treatment. RCM images were taken before and after treatment. The density, diameter, blood flow, and depth of PWS blood vessels were analyzed.
RESULTS
We found 44.4% PWS on the extremities (four out of nine subjects) were laser-resistant, which was significantly higher (P < 0.001) when compared with those PWS on the face (15.2%, 5 out of 33 subjects). The laser-resistant facial PWS blood vessels had significantly higher blood flow (1.35 ± 0.26 U vs. 0.89 ± 0.22 U, P < 0.001), larger blood vessel diameters (109.60 ± 18.24 µm vs. 84.36 ± 24.04 µm, P = 0.033) and were located deeper in the skin (106.01 ± 13.87 µm vs. 87.82 ± 12.57 µm, P < 0.001) in the skin when compared with laser-responsive PWS on the face. The average PWS blood vessel density (17.01 ± 4.63/mm vs. 16.61 ± 4.44/mm , P = 0.857) was not correlated to the laser resistance.
CONCLUSIONS
Laser-resistant PWS blood vessels had significantly higher blood flow, larger diameters, and were located deeper in the skin. RCM can be a valuable tool for a prognostic evaluation on laser-resistant lesions before treatment, thereby providing guidance for tailored laser treatment protocols, which may improve the therapeutic outcome. The limitations for this study include relative small sample size and acquisitions of different blood vessels before and after 2 months of treatment. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
Topics: Adolescent; Adult; Child; Child, Preschool; Dermis; Female; Humans; Infant; Lasers, Solid-State; Male; Microscopy, Confocal; Middle Aged; Port-Wine Stain; Treatment Failure; Young Adult
PubMed: 31310339
DOI: 10.1002/lsm.23134 -
Journal of the American Academy of... Dec 2023
Topics: Humans; Port-Wine Stain; Hair Removal; Lasers, Solid-State; Hemangioma, Capillary; Aluminum; Yttrium; Neodymium; Laser Therapy
PubMed: 37353158
DOI: 10.1016/j.jaad.2023.06.025 -
Lasers in Medical Science Dec 2022Laser therapy has become the golden standard of port wine stain (PWS), but complete clearance of resistant PWSs is still difficult. The application of photodynamic...
Laser therapy has become the golden standard of port wine stain (PWS), but complete clearance of resistant PWSs is still difficult. The application of photodynamic therapy (PDT) in the treatment of PWS shows potential in clinical practice, especially for large-area and deep lesions. In this work, in vivo animal experimental investigation on the coupling effect of PDT with multi-pulse laser (MPL) irradiation on the treatment of PWS was conducted by using a dorsal skin window chamber model. Through visualization of the thermal response of blood vessels and damage evaluation, it is found that the combination of PDT with MPL results in 96.2% more vascular injury than PDT alone and 90% more than MPL alone, thus reducing side effects such as purpura after treatment. The combined therapy also has the benefit of large treatment area, uniform fading effect, shortened light duration, and reduced photosensitizer admit.
Topics: Animals; Port-Wine Stain; Photothermal Therapy; Skin; Photosensitizing Agents; Photochemotherapy
PubMed: 36574038
DOI: 10.1007/s10103-022-03671-4 -
Photobiomodulation, Photomedicine, and... Sep 2021Port-wine stain (PWS) patients may simultaneously have accompanied soft tissue hypertrophy. The outcome of laser therapy can be poor. To study the imaging and...
Port-wine stain (PWS) patients may simultaneously have accompanied soft tissue hypertrophy. The outcome of laser therapy can be poor. To study the imaging and histopathological characteristics of PWS patients with facial overgrowth. We retrospectively assessed the effect of therapy on a subset of PWS patients with facial overgrowth. The degree of hypertrophy and the density of enhanced signals on T1-weighted magnetic resonance imaging (MRI) were independently graded by two radiologists using a quartile scale. Biopsies/resection of tissue deep to the facial muscle was reviewed and compared with flat PWS. Thirty-two PWS patients with facial hypertrophy and 15 patients with flat PWS were included. MRI revealed a statistically significant correlation between the degree of hypertrophy and the density of enhanced signals (3.02 ± 0.92 vs. 2.47 ± 0.69; < 0.01). Histological features of a subset of patients showed that vascular malformations existed in the dermis and also in the subcutaneous fat and muscle with much larger vessel diameters (fat, 0.048 vs. 0.020; muscle, 0.035 vs. 0.017) and thicker vessel walls (fat, 0.014 vs. 0.006; muscle, 0.010 vs. 0.006) (both < 0.05). The imaging and pathological findings indicate that capillary malformation in subcutaneous tissue might be a major cause of poor therapeutic effect of laser therapy for PWS. Clinical trial registration no.: ChiCTR1800014278.
Topics: Humans; Hypertrophy; Laser Therapy; Low-Level Light Therapy; Port-Wine Stain; Retrospective Studies
PubMed: 34546110
DOI: 10.1089/photob.2020.4982