The Effect of Optical Clearing Agent on the Treatment of Port-Wine Stains by Pulsed Dye Laser

doi:10.3969/j.issn.1673-0364.2020.03.005

Abstract

Abstract:

Objective To explore the ef?cacy of optical clearing agent (OCA) on the treatment of port wine stain (PWS) using pulsed dye laser (PDL).

Methods The lesions of 13 patients with PWS were divided into two treatment areas. One of the areas was treated by PDL after applying OCA (OCA+PDL area), the other one was treated by PDL only (PDL area). Each patient underwent three sessions with interval of 2 months. Chromameter and visual evaluation (VAS) were used to evaluate the ef?cacy and side effects of each area three months after the final sessions.

Results After three sessions of treatment, the chromameter and visual evaluation suggested no significant difference between each area. However, after the first session, the VAS of OCA+PDL area and PDL area were 2.69 and 2.07, respectively, showing a significant difference (P=0.025), suggesting that the former had a significant improvement in color spots after one single session. Permanent side effects were not observed in any patient.

Conclusion Compared with single use of PDL, the combined use of OCA does not improve the efficacy of PDL in treating PWS.

Key words: Port wine stain, Pulsed dye laser, Optical clearing agent, Glycerol

CLC Number:

R732.2

Yanyu CHEN, Wenxin YU, Gang MA, Xiaoxi LIN. The Effect of Optical Clearing Agent on the Treatment of Port-Wine Stains by Pulsed Dye Laser[J]. Journal of Tissue Engineering and Reconstructive Surgery, 2020, 16(3): 193-197.

Figures/Tables 6

Table 1

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References 24

[1]	Jacobs AH, Walton RG . The incidence of birthmarks in the neonate[J]. Pediatrics, 1976,58(2):218-222.
[2]	Geronemus RG, Ashinoff R . The medical necessity of evaluation and treatment of port-wine stains[J]. J Dermatol Surg Oncol, 1991,17(1):76-79.
[3]	Wagner KD, Wagner RF Jr . The necessity for treatment of childhood port-wine stains[J]. Cutis, 1990,45(5):317-318.
[4]	Strauss RP, Resnick SD . Pulsed dye laser therapy for port-wine stains in children: psychosocial and ethical issues[J]. J Pediatr, 1993,122(4):505-510.
[5]	Anderson RR, Parrish JA . Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation[J]. Science, 1983,220(4596):524-527.
[6]	Lanigan SW . Port-wine stains unresponsive to pulsed dye laser: explanations and solutions[J]. Br J Dermatol, 1998,139(2):173-177.
[7]	Huikeshoven M , Koster PH, de Borgie CA, et al. Redarkening of port-wine stains 10 years after pulseddye-laser treatment[J]. N Engl J Med, 2007,356(12):1235-1240.
[8]	Tuchin VV, Maksimova IL, Zimnyakov DA , et al. Light propagation in tissues with controlled optical properties[J]. J Biomed Opt, 1997,2(4):401-417.
[9]	Dunn AK, Smithpeter CL, Welch AJ , et al. Finite-difference time-domain simulation of light scattering from single cells[J]. J Biomed Opt, 1997,2(3):262-266.
[10]	Tuchin VV . Optical clearing of tissues and blood using the immersion method[J]. J Phys D Appl Phys, 2005,38(15):2497-2518.
[11]	Choi B, Tsu L, Chen E , et al. Determination of chemical agent optical clearing potential using in vitro human skin[J]. Laser Surg Med, 2005,36(2):72-75.
[12]	Bui AK, Mcclure RA, Chang J , et al. Revisiting optical clearing with dimethyl sulfoxide (DMSO)[J]. Laser Surg Med, 2009,41(2):142-148.
[13]	Wang RK, Xu X, Tuchin VV , et al. Concurrent enhancement of imaging depth and contrast for optical coherence tomography by hyperosmotic agents[J]. J Opt Soc Am B, 2001,18(7):948-953.
[14]	Genina EA, Bashkatov AN, Tuchin VV . Tissue optical immersion clearing[J]. Expert Rev Med Devic, 2010,7(6):825-842.
[15]	Zhu D, Larin KV, Luo Q , et al. Recent progress in tissue optical clearing[J]. Laser Photonics Rev, 2013,7(5):732-757.
[16]	Yu W, Ma G, Qiu Y , et al. Prospective comparison treatment of 595-nm pulsed-dye lasers for virgin port-wine stain[J]. Br J Dermatol, 2015,172(3):684-691.
[17]	Yu W, Ma G, Qiu Y , et al. Why do port-wine stains (PWS) on the lateral face respond better to pulsed dye laser (PDL) than those located on the central face[J] ? J Am Acad Dermatol, 2016,74(3):527-535.
[18]	Rah DK, Kim SC, Lee KH , et al. Objective evaluation of treatment effects on port-wine stains using Lab* color coordinates[J]. Plast Reconstr Surg, 2001,108(4):842-847.
[19]	Tremaine AM, Armstrong J, Huang YC , et al. Enhanced port-wine stain lightening achieved with combined treatment of selective photothermolysis and imiquimod[J]. J Am Acad Dermatol, 2012,66(4):634-641.
[20]	Cubeddu R, Pifferi A, Taroni P , et al. A solid tissue phantom for photon migration studies[J]. Phys Med Biol, 1997,42(10):1971-1979.
[21]	Vargas G, Chan EK, Barton JK , et al. Use of an agent to reduce scattering in skin[J]. Lasers Surg Med, 1999,24(2):133-141.
[22]	Vargas G, Barton JK, Welch AJ . Use of hyperosmotic chemical agent to improve the laser treatment of cutaneous vascular lesions[J]. J Biomed Opt, 2008,13(2):021114.
[23]	Vargas G, Readinger A, Dozier SS , et al. Morphological changes in blood vessels produced by hyperosmotic agents and measured by optical coherence tomography[J]. Photochem Photobiol, 2003,77(5):541-549.
[24]	Kane KS, Smoller BR, Fitzpatrick RE , et al. Pulsed dye laser-resistant port wine stains[J]. Arch Dermatol, 1996,132(7):839-841.

No.	Δa		ΔE		Blanching rate
No.	OCA+PDL	PDL	OCA+PDL	PDL	OAC+PDL	PDL
1	-1	-1	4.24	7.35	0.22	0.38
2	2	5	8.49	6.71	0.72	0.43
3	18	22	22.83	25.87	0.63	0.65
4	5	11	5.74	13.08	0.31	0.46
5	2	5	11.36	9.90	0.45	0.73
6	11	12	11.70	13.93	0.61	0.62
7	18	18	19.31	19.31	0.82	0.82
8	0.63	-0.38	3.95	3.60	0.39	0.31
9	5	5	9.11	10.72	0.72	0.72
10	-2.34	0.28	12.35	11.87	0.33	0.39
11	-3.35	-0.65	7.63	6.95	0.24	0.35
12	6.75	11.57	9.48	13.52	0.46	0.49
13	-6.39	-4.47	11.95	9.27	0.42	0.38

No.	第一次治疗后 after the first treatment		第二次治疗后 after the second treatment		第三次治疗后 after the third treatment
No.	OCA+PDL	PDL	OCA+PDL	PDL	OAC+PDL	PDL
1	1	1	2	2	3	3
2	2	2	4	4	5	5
3	2	2	4	4	5	5
4	3	2	3	3	4	4
5	4	4	5	5	5	5
6	4	2	4	3	4	4
7	3	3	4	4	5	5
8	3	1	4	3	4	4
9	3	2	3	2	3	3
10	2	2	2	2	3	3
11	4	2	4	3	4	4
12	2	2	2.5	2.5	3	3
13	2	2	2.5	2.5	3	3