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Retrospective study of the treatment of port-wine stains with 595-nm pulsed dye laser in 261 Chinese patients
摘要： Pulsed dye laser (PDL) at the wavelength of 595 nm is the common choice for the treatment of port-wine stains (PWSs). In this study, the efficacy of 595-nm PDL in treatment of PWSs in Chinese patients was investigated. A follow-up visit was performed on 261 Fitzpatrick skin type II–III Chinese patients with PWS who received more than two treatments with 595-nm PDL. Based on cosmetic improvement, treatment response was graded as follows: complete, if color blanching was > 90%; significant, if color blanching was 60–90%; moderate, if color blanching was 30–60%; and poor, if color blanching was < 30%. The efficacy of laser treatment on patients of different treatment numbers, ages, lesion locations, lesion colors, extents of hypertrophy, and laser pulse durations was evaluated. All patients improved following an average of almost 4 to 5 laser treatments. The earlier the intervention, the better the efficacy was. Lesions on cheek, neck, and forehead were better than that those on oral, eye periorbital, and nose areas. The purple group had a more excellent clearance, i.e., complete and significant clearance rate (53.6%), than the red group (36.1%). Treatment effect became worse as the extent of lesion hypertrophy increased. PWS lesions treated with short pulse durations of 0.45, 1.5, and 3 ms had better clearance (complete and significant clearance) rate of 56.5% than those treated with pulse durations of 6 ms or longer (34.8%). Pulsed dye laser with 595-nm laser equipped with dynamic cooling device is an effective option for the treatment of PWS in Chinese patients. Younger patients with lateral face position, larger vessel size (deeper color), and lesser hypertrophy received better clinical effect than the others. Treatment with short pulse duration of less than 3 ms for 4 to 5 times was recommended to treat PWS.
关键词： Chinese patients,Clinic review,Laser surgery,Port-wine stain
更新于2025-09-23 15:21:01
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Experimental investigations on thermal effects of a long-pulse alexandrite laser on blood vessels and its comparison with pulsed dye and Nd:YAG lasers
摘要： Laser has been widely used in the treatment of vascular skin diseases, such as port wine stain, due to the effect of selective photothermolysis in laser on biological tissue. The 755 nm alexandrite laser was expected to achieve better curative effect than the commonly used 585 or 595 nm pulsed dye laser (PDL) because of its deeper tissue penetration. In this study, the dorsal chamber model and microscopic visualization system were used to observe morphology changes on 42 blood vessels before and after irradiation with the 755 nm laser. Results showed that thermal effects of blood vessels intensified with the increase in energy, and high energy was required to produce the same thermal effect as the extension of pulse width. Different from 595 and 1064 nm lasers, partial vessel contraction was dominant thermal effect caused by the 755 nm laser. The bleeding injury rate and thermal effect of the 755 nm laser were between those of 595 nm PDL and 1064 nm Nd:YAG laser. The simulation results proved that 595 nm PDLs were effective for small and shallow target blood vessels. The 755 nm alexandrite lasers were effective in the treatment of hypertrophic and resistant blood vessels to PDL in the skin with low or moderate melanin concentration. The 1064 nm Nd:YAG laser was effective in the treatment of deeply buried and enlarged target blood vessels in the skin with high melanin concentration. The simulation results were supported by published clinical observations.
关键词： Laser therapy,Port wine stain,Vascular thermal effect,755 nm lasers
更新于2025-09-23 15:19:57
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Thermal coagulum formation and hemostasis during repeated multipulse Nd:YAG laser treatment of cutaneous vascular lesions: animal experiment study
摘要： Laser therapy has been widely used to treat port-wine stain (PWS) and other cutaneous vascular lesions via selective photothermolysis. High incident laser fluence is always prohibited in clinic to prevent the thermal damage in normal skin tissue, leading to insufficient energy deposition on the target blood vessel and incomplete clearance of PWS lesion. In this study, repeated multipulse laser (RMPL) irradiation was proposed to induce acute thermal damage to target blood vessels with low incident fluence (40 J/cm2 for 1064-nm Nd:YAG laser). The feasibility of the method was investigated using animal models. Repeated multipulse irradiation cycles with 10-min intervals were performed in RMPL. A hamster dorsal skin chamber model with a visualization system was constructed to investigate the instant generation of thermal coagulum and relevant hemostasis by thrombus formation during and after irradiation under 1064 nm Nd:YAG single multipulse laser (SMPL) and RMPL irradiation. The diameter of the target blood vessel and the size of thermal coagula were measured before and after laser irradiation. The reflectance spectra of the dorsal skin were measured by a reflectance spectrometer during RMPL. Stasis thermal coagula that clogged the vessel lumen were generated during SMPL irradiation with low incident fluence. However, there was no acute thermal damage of blood vessels. Reflectance spectra measurement showed that the generation of thermal coagula and subsequent thrombus formation increases blood absorption by more than 10% within the first 10 min after laser irradiation. Acute vessel thermal damage could be induced in the target blood vessel by RMPL with low incident fluence of 40 J/cm2. Compared with our previous SMPL study, nearly 30% reduction in incident laser fluence was achieved by RMPL. Low fluence RMPL may be a promising approach to improve the therapeutic outcome for patients with cutaneous vascular lesions by improving energy deposition on the target blood vessel.
关键词： Thermal coagula,1064-nm Nd:YAG laser,Port-wine stain,Repeated multiple pulse laser irradiation,Thrombus formation
更新于2025-09-23 15:19:57
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Immediate post‐irradiation dermoscopic vascular changes versus purpura as a therapeutic endpoint in pulsed‐dye laser treatment of port wine stains
摘要： Pulsed-dye laser (PDL) is the treatment of choice for port wine stain (PWS), and the development of purpura is considered a therapeutic endpoint. Changes in PWS vasculature observed by dermoscopy immediately after laser irradiation have been suggested to predict the minimal effective fluence. The current study aimed at comparing these changes with purpura as a therapeutic endpoint. Fifty-six PWS patients, randomized into two groups, received five monthly PDL sessions (595 nm and 10 mm spot size). At the first visit, patients received multiple gradually increasing test irradiations. Patients in the first group were treated with the lowest dose that resulted in 24-hr-lasting purpura, while patients in the second group were treated with the lowest dose that resulted in vessel disappearance observed by dermoscope. No statistically significant differences were observed between the two groups (the dermoscopic and the purpuric) regarding mean average improvement (42.4 and 37.32%, respectively, p = .32), grade of improvement (p = .44), and the rate of side effects (0 and 13.79%, respectively, p = .13). In conclusion, the immediate post-irradiation vessel disappearance (detected by dermoscope) is comparable, in safety and efficacy, to purpura as a therapeutic endpoint and maybe more time-saving and more accepted cosmetically.
关键词： pulsed-dye laser,port wine stain,dermoscopy
更新于2025-09-19 17:13:59
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Retrospective study of photodynamic therapy for pulsed dye lasera??resistant porta??wine stains
摘要： Pulsed dye laser-resistant port-wine stains present a therapeutic challenge. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy for treating these lesions. A total of 67 patients with pulsed dye laser-resistant cervicofacial port-wine stains were retrospectively assessed after undergoing photodynamic therapy mediated with a combination of hemoporfin and 532-nm light. For objective evaluation of photodynamic therapy efficacy, first, the colorimetric changes in the port-wine stain lesions were evaluated according to the L*a*b* color coordinate system, then the values of color changes (DE) and blanching rate were calculated. For subjective evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the subjective evaluation. Adverse events were recorded after treatment. The median DE decreased significantly from the pretreatment value of 13.42 to 9.90 at the 2-month follow up (P < 0.001). The median blanching rate of port-wine stains was 28.04% after an average of 1.21 sessions of photodynamic therapy. Based on the overall visual assessment, 46.2% patients showed excellent or good levels of improvement (>50% color blanching). Adverse events were minimal, transient and self-limiting. In conclusion, photodynamic therapy serves as an alternative means to treat pulsed dye laser-resistant port-wine stains.
关键词： pulsed dye laser,pulsed dye laser resistance,treatment efficacy,photodynamic therapy,port-wine stain
更新于2025-09-19 17:13:59
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Facial Hypertrophic Port-Wine Stain Treatment Combining Large Spot 532 nm Laser, High-Intensity Focused Ultrasound and Traction Threads
摘要： Vascular lasers are the gold standard treatment for treating facial capillary malformations commonly known as port-wine stains (PWSs). However, up to 65% of them are associated with significant soft tissue hypertrophy that cannot be satisfactorily addressed using vascular lasers. The authors report a 40-year-old Caucasian woman with a large PWS of the mid and lower face and neck. It was unilateral and associated with significant hypertrophy of the affected face that resulted in significant asymmetry. Both face and neck had been previously treated with several sessions of different vascular lasers: 'small spot' potassium titanyl phosphate (532 nm) laser, intense pulsed light devices, and pulsed-dye laser (PDL). Pulsed-dye laser produced partial improvement of lesional color and was associated with minor scarring on her neck. Every previous treatment was stopped after several sessions when no further improvement was achievable. The authors initiated treatment with large spot, short pulse 532 nm laser with contact cooling (ExcelV; Cutera, Inc., Brisabane, CA; fluence 9–10 J/cm2, pulse duration 6 milliseconds, 8-mm spot on the cheek and 7–9 J/cm2, 6–7 milliseconds, 9-mm spot on the neck) every 4 weeks for the vascular component of her PWS. After 6 sessions, the authors obtained 34.61% improvement in lesional color and area, measured with objective 3-dimensional digital photography as described previously. To improve soft tissue hypertrophy and facial asymmetry, high-intensity focused ultrasound (HIFU) treatment was introduced (Ultraformer III; Classys, Inc., Seoul, Republic of Korea). The authors used 3 transducers working at the depths of 4.5, 3.0, and 1.5 mm, with energies 0.7, 0.6, and 0.4 J, respectively. A total of 600 lines were utilized in 2 sessions of 300 each with 2-week intervals. After 6 months, repositioning of hypertrophic cheek skin was performed with poly-L-lactic acid traction threads (Silhuette-Soft; Sinclair Pharma Ltd., Chester, United Kingdom). The authors used 2 threads with 12 cones (6 on each side) in 'V' shape fashion from 2 entry points in preauricular area and achieved immediate (data not shown) and delayed satisfactory results (Figure 1). The patient reported greater satisfaction from improved facial asymmetry than from color modification.
关键词： Traction Threads,High-Intensity Focused Ultrasound,Facial Hypertrophic Port-Wine Stain,532 nm Laser
更新于2025-09-16 10:30:52
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Treatment of port wine stains with 595-nm pulsed dye laser in 27 pediatric patients: A prospective study in the Iranian population
摘要： Port wine stain (PWS) is a congenital vascular malformation, which is visible at the birth as the red patches, mostly on the face and neck. Previous studies have shown good efficacy and safety of 595-nm pulsed dye laser (PDL). Here, we have conducted a prospective study to assess the efficacy and safety profile of pediatrics with PWS, treated with 595-nm PDL. Twenty-seven patients (10 males and 17 females) with the mean age of 5.7 ± 2.8 (range 1–13) years old were included in the study. Following 6.2 (range 4–10) sessions of treatment, 70.74 ± 18.5% of improvement was detected three months after the final session. Fourteen (51.8%) patients achieved a higher than 75% of improvement; nine (33.4%) patients experienced 50%-75% improvement; four (14.8%) patients experienced a less than 50% improvement. V1 involvement and a marked improvement within the first five sessions found to be good prognostic factors. Regarding age, sex, skin type, color and size of the PWS, no significant association with therapeutic response were detected. Blister and crust, atrophic macules, and hyperpigmentation were noted in six (22.2%), one (3.7%), and one (3.7%), respectively. In conclusion, 595-nm PDL looks an effective and relatively safe therapeutic approach in the treatment of Iranian pediatric PWS patients.
关键词： Port wine stain,pediatric,pulsed dye laser
更新于2025-09-12 10:27:22
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Efficacy of 577‐nm Pro‐Yellow laser in port wine stain treatment
摘要： A port-wine stain (PWS) is a congenital capillary malformation that is seen in 0.3–0.5% of newborns. Although many types of lasers have been used to treat PWSs, few studies have investigated the efficacy of 577-nm Pro-Yellow lasers. The aim of this study was to establish the efficacy of Pro-Yellow lasers in PWS treatment. In total, 26 patients, comprising 15 females (57.7%) and 11 males (42.3%) with a mean age of 24.7 ± 11.8 (range 1–50) years were included in the study. All were treated with a 577-nm Pro-Yellow laser at 4-week intervals, 3–10 times. The sessions initially used scan mode and a fluence dose of 24 J/cm2 per session, on average. The mean dose was increased by 4 J/cm each session and the maximum dose administered was 44 J/cm2. A mean regression of 68.8 ± 13.9% in the size of the lesions over 5.23 ± 2.7 sessions was observed. There was no statistically significant difference between the female and male patients when they were compared in terms of the number of treatment sessions (p = .789) and treatment success (p = .39). These case series demonstrate that the Pro-Yellow laser is a safe and well-tolerated treatment for PWSs. However, deep-seated lesions required more treatment sessions and it was observed that clinically the lesions did not completely disappear.
关键词： Pro Yellow laser,577 nm laser,laser treatment,port-wine stain
更新于2025-09-11 14:15:04
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Treatment of port wine stain with Tixel‐induced rapamycin delivery following pulsed dye laser application
摘要： Background: Although pulsed dye laser (PDL) is considered the gold standard treatment for port wine stains (PWS), post PDL revascularization is one of the main causes of incomplete regression and recurrence. Recently, topical sirolimus have been shown to improve treatment outcome probably through minimizing post-laser revascularization. Objectives: We sought to evaluate the added value of the Tixel drug delivery system (DDS) to the PDL and topical rapamycin treatment for PWS. Materials and Methods: This case series includes 3 teenager patients with previously treated PWS with PDL. Upon enrollment, every stain was divided into A and B halves for treatment assignments to the following regimens: (A) PDL + DDS + Rapamycin; (B) PDL+ Rapamycin. Subjects were instructed to apply Rapamycin topically over the PWS twice daily for the entire treatment period. Assessment of the treatment and adverse reactions as well as photographs was performed at baseline and before every PDL treatment. Results: There were clinically significant differences in blanching responses favoring PWS receiving PDL + DDS + Rapamycin as compared to PDL + Rapamycin alone. Transient hyperpigmentation was noted in 1 patient. Two patients developed mild transient irritation and dermatitis following the treatment on both halves. Conclusion: The use of drug delivery system combined with topical rapamycin has no remarkable adverse effects, improves the results of PDL treatment for port wine stains, and can reduce the total number of required PDL sessions.
关键词： tixel,port wine stain,pulsed dye laser,Drug delivery,Rapamycin
更新于2025-09-11 14:15:04