The assessment of pulsed dye laser treatment of port-wine stains with reflectance confocal microscopy.
BACKGROUND
Reflectance confocal microscopy (RCM) is a noninvasive technique for evaluating cutaneous lesions with cellular level resolution close to conventional histopathology. The aim of this study is to observe the vascular changes in Port-wine (PWS) lesions and assess the clinical efficacy of Pulsed Dye Laser (PDL) treatment by examining vessel diameter and density with RCM.


METHODS
Eleven adult patients with PWS, each had four test patches carried out with different pulse durations (1.5, 3, 6, and 10 ms), respectively; fluences of 9-12 J/cm²; and a spot size of 7 mm. The PDL treatment was repeated 3-5 times at a 2-month interval. Photographs and measurements with RCM were taken before each treatment and 2 months after the last treatment.


RESULTS
The PDL treatment exhibited increasing clearance with reducing pulse durations. Vessel diameters and densities were significantly decreased in the same pulse-duration groups after treatment. There was significant difference between 1.5 ms pulse-duration group and other pulse-duration groups in reducing blood vessel diameter at the depth of 150 μm.


CONCLUSIONS
RCM can be used to assess the clinical efficacy of PDL treatment.
Department of Dermatology, Huashan Hospital, Fudan University , Shanghai , P. R. China.
Jie
J
Ren
Hui
H
Qian
Leihong
L
Xiang
Zhanyan
Z
Pan
Lu
L
Zhong
Shuxian
S
Yan
Michael H
MH
Gold
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D055806:Microvessels / Q000473:pathology*; D019339:Port-Wine Stain / Q000473:pathology* / Q000601:surgery*; D012867:Skin / Q000098:blood supply; D016896:Treatment Outcome; D055815:Young Adult