title: Histochemical Evaluation of the Vessel Wall Destruction and Selectivity After Treatment with Intense Pulsed Light in Capillary Malformations.
abstract: BACKGROUND
  Among the different approaches for improving the effectiveness in the treatment of Capillary Malformations type Port Wine Stain (CM type PWS) are the intense pulsed light sources. There are few clinical studies prove useful in the treatment of CM. Furthermore, no studies have been published yet demonstrating the histological effects of IPL in CM.
  
  
  OBJECTIVE
  To assess the histological effects of pulsed light in capillary malformations type port wine stain. We wanted to compare epidermal, dermal and vessel wall damage after treatment with different combinations of IPL parameters.
  
  
  METHODS
  Fifty-five post-treatment biopsies were performed in 15 consenting patients with CM and stained with nitroblue-tetrazolium chloride (NBTC). Patients had not been treated previously.
  
  
  RESULTS
  Fifteen patients with CM, with a median age of 39 years-old were enrolled in this study. In this series, the patients with the most severe epidermal damage were those with a darker phototype. Pink CM were especially resistant to treatment, even using high fluences, short pulse durations and stacking pulses. Longer intra- and interpulse delays were effective in purple CM, achieving adequate vessel destruction.
  
  
  CONCLUSIONS
  IPL devices provide a vast amount of treatment possibilities and further studies are necessary to optimize therapeutic approaches to CM. In this study we have observed the histological effects of different pulses on the MC type PWS.
authors.affiliation: Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain. Electronic address: emiliano@doctoremilianogrillo.com.
authors.forename: E
authors.initials: E
authors.lastname: Grillo
authors.affiliation: Clínica Universitária de Dermatologia, Hospital de Santa Maria-Centro Hospital Norte, Lisboa, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Rita Travassos
authors.affiliation: Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Boixeda
authors.affiliation: Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Cuevas
authors.affiliation: Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Pérez
authors.affiliation: Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Paoli
authors.affiliation: Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Jaén
mesh_terms: D000328:Adult; D002196:Capillaries / Q000473:pathology*; D020405:Dermis / Q000473:pathology*; D004817:Epidermis / Q000473:pathology*; D018324:Hemangioma, Capillary / Q000209:etiology; D006801:Humans; D053685:Laser Therapy; D010789:Phototherapy / Q000009:adverse effects*; D019339:Port-Wine Stain / Q000628:therapy*; D016896:Treatment Outcome
keywords: Capillary malformations; Cloruro de nitroazul-tetrazolio (NBTC); Fluence; Fluencia; Fototermólisis selectiva; Histochemical; Histoquímica; Intense pulsed light (IPL); Luz pulsada intensa (IPL); Malformaciones capilares; Multiple pulses; Múltiples pulsos; Nitroblue-tetrazolium chloride (NBTC); Pulsos consecutivos; Selective photothermolysis; Stacking