NONINVASIVE DETERMINATION OF PORT-WINE STAIN ANATOMY AND PHYSIOLOGY FOR OPTIMAL LASER TREATMENT STRATEGIES

The treatment of port wine stains (PWSs) using a flashlamp-pumped puls ed dye laser is often performed using virtually identical irradiation parameters. Although encouraging clinical results have been reported, we propose that lasers will only reach their full potential provided t reatment parameters match individual PWS anatomy and physiology. The p urpose of this paper is to review the progress made on the technical d evelopment and clinical implementation of (i) infrared tomography (IRT ), optical reflectance spectroscopy (ORS) and optical low-coherence re flectometry (OLCR) to obtain in vivo diagnostic data on individual PWS anatomy and physiology and (ii) models of light and heat propagation, predicting irreversible vascular injury in human skin, to select opti mal laser wavelength, pulse duration, spot size and radiant exposure f or complete PWS blanching in the fewest possible treatment sessions. A lthough non-invasive optical sensing techniques may provide significan t diagnostic data, development of a realistic model will require a bet ter understanding of relevant mechanisms for irreversible vascular inj ury.