An overview of clinical and experimental treatment modalities for port wine stains

Abstract

Port wine stains (PWS) are the most common vascular malformation of the skin, occurring in 0.3% to 0.5% of the population. Noninvasive laser irradiation with flashlamp-pumped pulsed dye lasers (selective photothermolysis) currently comprises the gold standard treatment of PWS; however, the majority of PWS fail to clear completely after selective photothermolysis. In this review, the clinically used PWS treatment modalities (pulsed dye lasers, alexandrite lasers, neodymium:yttrium-aluminum-garnet lasers, and intense pulsed light) and techniques (combination approaches, multiple passes, and epidermal cooling) are discussed. Retrospective analysis of clinical studies published between 1990 and 2011 was performed to determine therapeutic efficacies for each clinically used modality/technique. In addition, factors that have resulted in the high degree of therapeutic recalcitrance are identified, and emerging experimental treatment strategies are addressed, including the use of photodynamic therapy, immunomodulators, angiogenesis inhibitors, hypobaric pressure, and site-specific pharmaco-laser therapy.

Assessment of the role of LASER-Doppler in the treatment of port-wine stains in infants

“…It provides us with a better knowledge of microcirculation [13]. This allows us to refine and improve treatment by modifying the PDL parameters and the length of the intervals between sessions in order to adapt to each individual case.…”

Skin-light interaction of three main chromofores in skin affected by Port Wine Stain

“…Now, a suitable wavelength to reach the dermis can be selected from Figure 2b. According to the data, a wavelength of 690 nm can be used in a PWS treatment considering that PWS in in the papillary dermis [13] which has a thickness between 0.15 -0.2 mm [11]. This is an easy mode to obtain a wavelength capable to penetrate into the skin layers and reach the dermis.…”

The Effectiveness of Port wine Stain Laser Treatment in Children

“…В настоящее время «золотым стандартом» лече-ния КАД у детей является терапия импульсным лазером на красителе (ИЛК) [8]. Световые волны, излучаемые лазерными аппаратами, проникают через эпидермис и поглощаются в дерме хромофо-ром-мишенью, в данном случае -гемоглобином.…”

“…Пиковое поглощение светового импульса гемо-глобином зависит от степени его насыщенности кислородом. Так, для оксигемоглобина пиковое поглощение составляет 577 нм, для карбоксиге-моглобина -около 585 нм [8].…”