DYNAMIC EPIDERMAL COOLING DURING 1500 S PULSED DYE LASERTREATMENT OF PORT

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A port wine stain (PWS) is a vascular malformation found in approximately 0.3% of children (1). These lesions are generally noted at birth as a faint pink macule which, as the patient ages, thickens and darkens to a red-purple color. Histologically, PWS birthmarks consist of dermal, dilated, capillary-like vessels with no endothelial proliferation (2). PWS birthmarks may be located anywhere on the body but are commonly found on the face and neck where they have serious psychological consequences. Patients are often perceived by others as "marked" which may adversely affect personality development. For this reason and because PWS birthmarks are unlikely to involute with time, patients or their families often seek treatment. Developing acceptable treatment options has been difficult. Early attempts at treatment included cosmetic cover-up, skin grafting, radiation, dermabrasion, cryosurgery, tattooing and electrotherapy but none of these modalities provided cosmetically acceptable results. The development of lasers and their ability to damage PWS blood vessels offered another treatment option. A variety of lasers have been utilized for the treatment of PWS birthmarks but the flashlamp-pumped pulsed dye laser (FLPDL) has offered the best results with the lowest incidence of side effects. The yellow light produced by the FLPDL is preferentially absorbed by hemoglobin allowing more selective destruction of the ectatic capillaries in the dermis.