Abstract. Port-wine stain is a congenital birthmark consisting of an abnormal density of blood vessels in the upper dermis. The enlarged blood volume gives the lesion a red to purple colour. The aim of the treatments is to destroy the vessels to the extent necessary for obtaining a normal skin coloration. Thus, in principle, all relevant information about the lesion should be contained in a reflectance spectrum in the visible. However, the relation between the reflectance spectrum and tissue parameters such as scattering, melanin content and blood distribution is somewhat composite. This work tries to enlighten this relation in terms of a very simple analytical mathematical model, and it is demonstrated that such a model at least will contribute to a qualitative understanding of the relevance of the various parameters.

Abstract. Selective photothermolysis with pulsed lasers is presumably the most successful therapy for port-wine stain birthmarks (flammeus nevi). Selectivity is obtained by using an optical wavelength corresponding to high absorption in blood, together with small absorption in tissues. Further on, the pulse length is selected to be long enough to allow heat to diffuse into the vessel wall, but simultaneously short enough to prevent thermal damage to perivascular tissues. The optical wavelength and pulse length are therefore dependent on vessel diameter, vessel wall thickness and depth in dermis. The present work demonstrates that in the case of a 0.45 ms long pulse at 585 nm wavelength, vessels of 40~0 Fm require minimum optical fluence. Smaller vessels require higher fluence because the amount of heat needed to heat the wall becomes a substantial fraction of the absorbed optical energy. Larger vessels also require a higher dose because the attenuation of light in blood prevents the blood in the centre of the lumen from participating in the heating process. It is shown that the commonly used optical dose in the range of 6-7 J cm-2 is expected to inflict vessel rupture rather than thermolysis in superficially located vessels. The present analysis might serve to draw guidelines for a protocol where the optical energy, wavelength and pulse length are optimized with respect to vessel diameter and depth in dermis.