Lasers in Medicine: Healing with Light
Suzanne Amador Kane, Boris A. Gelman in Introduction to Physics in Modern Medicine, 2020
These infrared lasers take advantage of the presence of water in the skin to provide an ability to remove skin and body tissues in general. However, the absorption specificity of lasers operating in the visible has opened new possibilities in dermatology not available with conventional techniques. In particular, lasers can eradicate certain blemishes otherwise resistant to removal. This is especially true of port-wine stains, a type of birthmark often covering extensive regions of the body. The fine mesh of blood capillaries that makes up the port-wine stain is not dangerous, but people may wish to have them removed for cosmetic reasons (Figure 3.1a). A favored treatment for removing port-wine stains is the use of a pulsed dye laser operating at a yellow wavelength of 585 nm. This corresponds to a peak in the absorption of hemoglobin (Figure 3.25), giving good destruction of the blood vessels, and fading the port-wine stains by 80% to 90%. The more transparent surrounding skin absorbs much less of the laser light, and hence there is no scarring. The same laser can also be used for treating unsightly superficial capillaries on the legs, often called spider veins.
Practice Paper 1: Answers
Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar in Get ahead! Medicine, 2016
A deep capillary naevus (or port-wine stain) is a malformation of the capillaries in the deep and superficial dermis. These are congenital malformations that can occur anywhere in the body, but are most often found unilaterally on the face. Occasionally, a port-wine stain is associated with seizures, learning difficulties and eye abnormalities (glaucoma and optic atrophy) due to underlying cranial malformations. This is known as Sturge–Weber syndrome and is usually associated with a port-wine stain in the distribution of the ophthalmic or maxillary division of the trigeminal nerve. (Trigeminal, from Latin tri = three + gemini = twins; which together means ‘triplets’. The trigeminal nerve has three divisions.)
The skin and subcutaneous tissues
Kevin G Burnand, John Black, Steven A Corbett, William EG Thomas, Norman L Browse in Browse’s Introduction to the Symptoms & Signs of Surgical Disease, 2014
Red–blue: Strawberry naevus.Port wine stain.Spider naevus.Campbell de Morgan spot.Telangiectases.Pyogenic granuloma.
Topical photodynamic therapy with 5-aminolevulinic acid in Chinese patients with Rosacea
Published in Journal of Cosmetic and Laser Therapy, 2019
Yan Sun, Lianghong Chen, Yuhui Zhang, Xinghua Gao, Yan Wu, Hongduo Chen
PDT has numerous antineoplastic, anti-inflammatory, and anti-microbial effects (19). In the treatment of condylomata acuminata and skin carcinoma, PDT induces necrosis/apoptosis in dysplastic/neoplastic cells and influences tumor microvasculature. Additionally, it generates high levels of reactive oxygen species to induce potent vascular damage and hypoxia. PDT has also proven to be effective in the treatment of port-wine stain. In this condition, the photosensitizer is activated by light at an appropriate wavelength, and it circulates in blood vessels. Selective photodynamic damage to the walls of vessels associated with port-wine stain ultimately closes the vessels and causes blanching without destruction of surrounding skin tissue (20,21). The photosensitizer used to treat port-wine stain is hemporfin, which is different from ALA. However, another study showed that ALA is also effective for vessels (22). To treat rosacea, especially ET rosacea, vessels may be destroyed partially or totally by PDT, thus alleviating or even eliminating erythema and/or telangiectasia.
Extraocular muscle enlargement in retinoencephalofacial angiomatosis
Published in Orbit, 2020
Alisha Kamboj, Andrea A. Tooley, Kyle J. Godfrey, Mary D. Maher, Hermann D. Schubert, Michael Kazim
A 22-year-old female presented with five years of progressive left exophthalmos, in the absence of thyroid dysfunction and other systemic disease. She endorsed occasional blurred vision but denied diplopia. She had a left-sided, congenital vascular facial malformation, previously diagnosed as a port-wine stain. Her past surgical history included left retinal laser treatment for peripheral neovascularization and reconstruction of the upper lip to address the vascular malformation. Pathologic inspection of the vascular malformation at that time was consistent with a GLUT-1 negative venous malformation. Magnetic resonance imaging (MRI) demonstrated diffuse enlargement of the left extraocular and temporalis muscles with prominent vessels in the temporalis muscle (Figure 1a) and intraconal fat (Figure 1b). Non-contrast magnetic resonance angiogram (MRA) failed to demonstrate evidence for high flow vascular malformation.
Treatment of port wine stains with 595-nm pulsed dye laser in 27 pediatric patients: A prospective study in the Iranian population
Published in Journal of Cosmetic and Laser Therapy, 2019
Ali Sadeghinia, Saba Moghaddas, Soheil Tavakolpour, Amir Teimourpour, Maryam Danespazhooh, Hamidreza Mahmoudi
Port wine stain (PWS) is a cutaneous congenital vascular malformation affecting males and females and all racial groups equally. It is characterized by pink to erythematous skin patches, especially on the face and neck; and has a low incidence of 0.3%–0.5% of the newborn (1). Although its exact etiology has remained unclear, PWS develops as the result of ectatic capillaries in the skin. Most of PWS cases are sporadic, although familial PWS have been described in the literature (2) which suggests the role of genetic background in its development. For example, the somatic variation in specific genes, such as GNAQ has been shown as a factor for the development of PWS (3,4). In spite of being harmless, it can be associated with important cosmetic and psychological implications.