title: Why do port-wine stains (PWS) on the lateral face respond better to pulsed dye laser (PDL) than those located on the central face?
abstract: BACKGROUND
  After pulsed dye laser (PDL) treatment, facial lateral port-wine stains (PWS) clear quicker and more completely than central PWS do.
  
  
  OBJECTIVE
  We sought to investigate whether the difference in the efficacy of the treatment between central and lateral facial PWS was related to different histologic manifestations.
  
  
  METHODS
  Thirteen patients with PWS had biopsies and underwent PDL treatments in both central and lateral areas of the face. The hypothesis was tested by correlating the PWS response to PDL with the depth and diameter of the PWS vessels. The clinical efficacy was assessed by chromameter 2 months after the final PDL treatment, whereas diameter and depth of PWS vessels were measured in biopsy specimens.
  
  
  RESULTS
  All patients were treated on central and lateral facial sites. The chromameter evaluation showed that the average blanching rate was 34.01% and 8.68% for lateral and central facial sites, respectively (P < .05), which suggests a better response to PDL treatment in the lateral than in the central area. Histologic manifestations showed that vessels in the lateral regions were primarily located in the papillary dermis, whereas in the central regions they were extensively distributed from the dermis into the subcutaneous tissue.
  
  
  CONCLUSIONS
  The small number of cases included in this study and the lack of follow-up longer than 2 months constitute limitations.
  
  
  CONCLUSIONS
  Lateral facial PWS respond better to PDL than PWS located in the central face. Differences in vessel location and diameter may be responsible for the variations in PWS response to PDL.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Wenxin
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Ma
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Yunbo
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Tianyou
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Chang
authors.affiliation: Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Henghua
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Plastic and Reconstructive Surgery, Laser Center, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China. Electronic address: linxiaoxi@126.com.
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005145:Face / Q000473:pathology*; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D019339:Port-Wine Stain / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: anatomical; different site; efficacy; histologic; location; port-wine stain; pulsed dye laser; response