The Medical Necessity of Evaluation and Treatment of Port‐Wine Stains

Geronemus, Roy G.; Ashinoff, Robin

doi:10.1111/j.1524-4725.1991.tb01597.x

Cited by 169 publications

(99 citation statements)

References 20 publications

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“…1 They often constitute a significant cosmetic problem, and, if left untreated, are likely to develop nodular or hypertrophic areas which are prone to spontaneous or trauma-induced bleeding and consecutive infection. 2,3 The long-term psychological effects of PWS are documented widely but have been shown to be mitigated significantly after treatment. 4 Although flashlamp-pumped pulsed dye laser (PDL) treatments are widely considered the treatment of choice for PWS, fewer than 20% of patients experience complete lightening using this method, whereas 20% to 30% are considered "poor responders".…”

Section: Introductionmentioning

confidence: 99%

Simulating light transport through skin for color prediction of port wine stain lesions: a review

2012

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Abstract. A survey of the literature is presented regarding the simulation of port wine stain (PWS) skin color. Knowledge of PWS features, such as the depths and diameters of affected vessels, is essential for informing laser treatment. These may be determined through the inverse application of a skin model. The techniques which have been applied to achieve this are analyzed in detail. Radiative transfer (RT) is found to be the preferred method of simulation. By far the most common approximations to RT are the diffusion approximations, which have been applied successfully in the past and Monte Carlo techniques, which are now the methods of choice. As the requirements for improvement of laser treatment on an individual basis continues, the needs for further work towards accurate estimations of individual optical coefficients and robust, flexible simulation techniques are identified.

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Section: Introductionmentioning

confidence: 99%

Simulating light transport through skin for color prediction of port wine stain lesions: a review

2012

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“…Personality development is adversely influenced in virtually all patients by the negative reaction of others to a ''marked'' person [4][5][6]. In childhood, PWSs are faint pink macules, but the lesions tend to darken progressively to red-purple [7]. The subsequent hypertrophy of underlying bone and soft tissue further disfigures the facial features of many patients.…”

Section: Introductionmentioning

confidence: 99%

Comparing the effectiveness of 585‐nm vs. 595‐nm wavelength pulsed dye laser treatment of port wine stains in conjunction with cryogen spray cooling

et al. 2002

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Background and Objectives: The objective of this study was to compare the efficacy and safety of cryogen spray cooled laser treatment (CSC-LT) at wavelengths of 585 nm vs. 595 nm for port wine stain (PWS) birthmarks in a large series of patients. Study Design/Materials and Methods: A retrospective review was conducted of 64 patients with PWS treated with the ScleroPLUS 1 [Candela (Wayland, MA)] pulsed dye laser (l ¼ 585 or 595 nm wavelength; spot size 7 mm, t p ¼ 1,500 microseconds) over a 3-year period. Subjects' ages ranged between 3 months and 64 years; there were 42 females and 22 males, all of whom were Asian. Number of treatments ranged from 1 to 6. Duration of treatment ranged from 6 months to 2 years 11 months, with a mean of 12 months. Patients (n ¼ 32) received CSC-LT (585 nm) using radiant exposures of 7-10 J/cm 2 . A second group of patients (n ¼ 32) received CSC-LT (595 nm) using radiant exposures of 7-10 J/cm 2 . The primary efficacy measurement was the quantitative assessment of blanching response scores for CSC-LT (585 nm) versus CSC-LT (595 nm). Patients were monitored for adverse effects. Results: Based on chi-squared analysis, there were clinical, and statistically significant, differences in blanching response scores favoring PWS receiving CSC-LT (585 nm) as compared to CSC-LT (595 nm) (P < .001). Transient hyperpigmentation was noted in 43.7% (n ¼ 14) and 37.5% (n ¼ 12) of patients in the CSC-LT (585 nm) and CSC-LT (595 nm) groups, respectively. In both groups, transient hyperpigmentation resolved in all patients within 1 year. Permanent hypopigmentation or scarring was not observed in either group. Conclusions: CSC-LT (585 nm) resulted in superior blanching as compared to CSC-LT (595 nm). Further study is required to optimize wavelength selection on an individual patient basis during PWS therapy in order to improve treatment results.

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“…[4][5][6] In childhood, PWSs are faint pink macules, but the lesions tend to darken progressively to red-purple. 7) The subsequent hypertrophy of underlying bone and soft tissue further disfigures the facial features of many patients. Histopathologic studies of PWS show a nor-…”

Section: Introductionmentioning

confidence: 99%

Update on Flashlamp Pumped Pulsed Dye Laser Treatment for Port Wine Stains (Capillary Malformation) Patients

Hsiao

Chang

2011

LASER THERAPY

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Background and Aims: Currently, the method of choice for the treatment of port-wine stains is laser photocoagulation. Because of evolving treatment options, it is no longer enough for portwine stains merely to be lightened through laser treatment. The best course of management consists of the most appropriate laser that will produce the most complete clearing of a lesion in the fewest treatment sessions with the least morbidity. The goal is generally accomplished with the use of yellow-light lasers. Materials (Subjects) and Methods: Absorption of laser energy by melanin causes localized heating in the epidermis, which may, if not controlled, produce permanent complications such as hypertrophic scarring or dyspigmentation. Refinements of the results can be achieved by using the flashlamp-pumped pulsed dye laser (FLPDL) in conjunction with the cryogen spray cooling (CSC) system. In our related studies, the infrared thermal image instrument is used for doctors in determining the optimum laser light dosage and preventing the side effects caused by FLPDL. Topic application of angiogenesis inhibitor (Imiquimod) in conjunction with pulsed dye laser treatment for the PWS patients has been assessed for improvement of FLPDL treatment. Results: We present the clinical effect of FLPDL, and the efficacy and safety of cooled laser treatment of PWS birthmarks. Our clinical outcome in the laser treatment of patients with PWS has been achieved to maximize thermal impact on targeted vessels, while minimizing adverse complications. Conclusions: CSC in conjunction with FLPDL can improve the treatment of PWS. The infrared image instrument is helpful for doctors in determining the optimum laser light dosage. Topic application of angiogenesis inhibitor (Imiquimod) in conjunction with laser treatment for the PWS patients is promising in the near future.

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The Medical Necessity of Evaluation and Treatment of Port‐Wine Stains

Cited by 169 publications

References 20 publications

Simulating light transport through skin for color prediction of port wine stain lesions: a review

Simulating light transport through skin for color prediction of port wine stain lesions: a review

Comparing the effectiveness of 585‐nm vs. 595‐nm wavelength pulsed dye laser treatment of port wine stains in conjunction with cryogen spray cooling

Update on Flashlamp Pumped Pulsed Dye Laser Treatment for Port Wine Stains (Capillary Malformation) Patients

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