3-DIMENSIONAL RECONSTRUCTION OF PORT-WINE STAIN VASCULAR ANATOMY FROMSERIAL HISTOLOGICAL SECTIONS

Port wine stains (PWSs) treated with a flashlamp-pumped pulsed dye las er show a variability in clinical response that is incompletely unders tood. To identify any vascular structure that might adversely affect t reatment response, we obtained a three-dimensional reconstruction of t he vascular anatomy of a non-responsive, light-purple superficial PWS on the forearm. The reconstructed PWS consisted of multiple clusters o f small diameter (10-50 mu m) blood vessels. We propose that this and similar structures, which have not been identified in the literature, have limited the efficacy of laser therapy. Further study is required to clarify the role of vessel clusters for laser treatment of PWSs, an d the corresponding dosimetry necessary to clear non-responsive lesion s. We expect that three-dimensional reconstruction of PWS vascular ana tomy will provide the basis for (i) accurate PWS classification, (ii) guidance for selection of more effective laser dosimetry, and (iii) a standard against which to assess non-invasive diagnostic imaging techn iques.