title: Description and analysis of treatments for port-wine stain birthmarks.
abstract: Port-wine stain (PWS) birthmarks are congenital, low-flow vascular malformations of the skin. Lasers are the modality of choice for the treatment of PWS birthmarks, and for most patients the pulsed-dye laser in conjunction with epidermal cooling offers the greatest efficacy and safety. Other light devices, including the 532-nm frequency-doubled Nd:YAG laser, intense pulsed light, 1064-nm Nd:YAG laser, and combined 1064/532-nm system, may be useful during a treatment course for resistant PWS. Laser treatment results in blanching of most lesions, although complete resolution may not occur and some resistant PWS birthmarks respond minimally, if at all. Factors limiting laser treatment include variable vascular geometry, inadequate damage of some vessels, and lesional posttreatment recurrence as a result of neovascularization. Alternative or adjunct treatment options that address these limitations should be explored, including noninvasive real-time imaging to optimize the selection of treatment settings, photodynamic therapy, and perioperative use of antiangiogenic compounds.
authors.affiliation: Beckman Laser Institute, Irvine, CA 92612, USA. KMKelly@uci.edu
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
authors.forename: Bernard
authors.initials: B
authors.lastname: Choi
authors.forename: Samantha
authors.initials: S
authors.lastname: McFarlane
authors.forename: Alison
authors.initials: A
authors.lastname: Motosue
authors.forename: Byungjo
authors.initials: B
authors.lastname: Jung
authors.forename: Misbah H
authors.initials: MH
authors.lastname: Khan
authors.forename: Julio C
authors.initials: JC
authors.lastname: Ramirez-San-Juan
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D004954:Esthetics; D005148:Facial Dermatoses / Q000175:diagnosis / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019339:Port-Wine Stain / Q000473:pathology* / Q000532:radiotherapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome