COMBINED PHOTODYNAMIC AND PULSED DYE LASER TREATMENT OF PORT WINE STAINS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者的研究机构。 鲜红斑痣（PWS）是一种先天性皮肤血管畸形，在美国有150万患者。 脉冲染料激光（PDL）是治疗这些病变的标准治疗方法，通过选择性靶向组织血管系统，可减轻某些PWS患者的这些病变。 然而，很少有患者（< 10%）的病变完全变白，通常需要多次治疗（5 - 30次或更多）（1）。 限制许多患者PWS病变变白的一个主要因素是PDL去除小（直径小于20 m）浅表血管的能力有限，这对这些胎记的临床表现有显著影响（2）。 选择性靶向组织脉管系统的另一种高效方法是光动力疗法（PDT），其利用化学光敏剂和光来产生单线态氧自由基（3）。 使用红光和血管特异性光敏剂的PDT已在一些小型试验中用于PWS治疗（4、5、6）。 观察到令人印象深刻的病变减轻;然而，由于使用长波长红光引起的全部和深部血管破坏，在某些病例中也发生了轻度瘢痕形成。 此外，患者的光敏性延长（> 30天）。

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. Port wine stains (PWS) are congenital vascular malformations of the skin present in 1.5 million patients in the United States. The pulsed dye laser (PDL) is the standard of care for treatment of these lesions and by selectively targeting tissue vasculature, lightens these lesions in some PWS patients. However, few patients (< 10%) achieve complete blanching of their lesion and multiple treatments (5 -30 or more) are generally required (1). One primary factor limiting PWS lesion blanching for many patients is the limited ability of the PDL to remove small (less than 20 m diameter) superficial vessels, which contribute significantly to the clinical appearance of these birthmarks (2). Another highly effective method for selectively targeting tissue vasculature is photodynamic therapy (PDT), which utilizes a chemical photosensitizer and light to generate singlet oxygen radicals (3). PDT using red light and vascular specific photosensitizers has been implemented in a few small trials for PWS treatment (4,5,6). Impressive lesion lightening was noted; however, mild scarring also occurred in some cases as a result of total and deep vascular destruction induced by the use of long wavelength red light. Further, patients experienced prolonged photosensitivity (30 days).