An overview of clinical and experimental treatment modalities for port wine stains - 13/07/12
Reprint requests: Michal Heger, PhD, Department of Experimental Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Abstract |
Port wine stains (PWS) are the most common vascular malformation of the skin, occurring in 0.3% to 0.5% of the population. Noninvasive laser irradiation with flashlamp-pumped pulsed dye lasers (selective photothermolysis) currently comprises the gold standard treatment of PWS; however, the majority of PWS fail to clear completely after selective photothermolysis. In this review, the clinically used PWS treatment modalities (pulsed dye lasers, alexandrite lasers, neodymium:yttrium-aluminum-garnet lasers, and intense pulsed light) and techniques (combination approaches, multiple passes, and epidermal cooling) are discussed. Retrospective analysis of clinical studies published between 1990 and 2011 was performed to determine therapeutic efficacies for each clinically used modality/technique. In addition, factors that have resulted in the high degree of therapeutic recalcitrance are identified, and emerging experimental treatment strategies are addressed, including the use of photodynamic therapy, immunomodulators, angiogenesis inhibitors, hypobaric pressure, and site-specific pharmaco-laser therapy.
Le texte complet de cet article est disponible en PDF.Key words : angiogenesis inhibitors, epidermal cooling, hypobaric pressure, immunomodulators, photodynamic therapy, pulsed dye laser, site-specific pharmaco-laser therapy, superficial vascular and capillary malformations
Abbreviations used : FDA, IPL, Nd:YAG, PDL, PDT, PWS, RPM, SSPLT
Plan
| Dr Aguilar was funded by grant HD042057 from the National Institutes of Health (NIH). Dr Kelly was funded by the NIH (AR51443 and HD065536), the American Society for Laser Medicine and Surgery, and a research grant from Graceway Pharmaceuticals. |
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| Work was in part performed at Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, campus Querétaro, México, during sabbatical leave (Dr Aguilar). |
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| Disclosure: Dr Aguilar was a consultant for Aesthera and Lumenis. Dr Heger holds intellectual property rights regarding site-specific pharmaco-laser therapy. Drs Chen, Ghasri, van Drooge, Wolkerstorfer, and Kelly have no conflicts of interest to declare. |
Vol 67 - N° 2
P. 289 - août 2012 Retour au numéro
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