Port-wine stains (PWS) are congenital vascular malformations, consisting of ectatic capillaries and post-capillary venules in the papillary and mid-reticular layers of the dermis. PWS progressed slowly increased with age in 70% patients, the color deepened, the thickness increased, the plaques and nodules formed. PWS mainly occurs in the face and neck regions, which may influence psychological well-being and physical impact.
Pulsed dye laser (PDL) is the standard treatment for PWS with excellent cosmetic outcome without a scar. Although red PWS shows good therapeutic effect with PDL, purple and hypertrophic PWS show tolerance which is associated with depth and diameter of vessels.
At present, subjective evaluation method show little stable, commonly used to evaluate the efficacy of the treatment of PWS by different therapy. Spectrophotometric can detect skin color changes before and after the treatment, naming bleaching rate calculation. Reflectance confocal microscopy RCM, optical coherence tomography (OCT) can be used to observe the change of blood vessels, but most of departments do not have spectrophotometric, RCM and OCT.
We used dermascopy, VISIA, doppler ultrasound and two-dimensional (2D) ultrasound to evaluate treatment efficacy of PWS. Hypertrophic PWS showed reduction of blood flow by doppler ultrasound and attenuation of dermis and subcutaneous tissue by 2D ultrasound. Upon dermascopic examination, we found different types of PWS showed reduction of vessels and faded in color after treatment. In addition, VISIA could be used to calculate the mutative area of erythema by treatment. Using non-invasive evaluation technique could be effective and scientific to evaluate the curative effect.
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