Abstract
Nevus flammeus (NF) is a congenital vascular malformation. To investigate the acute effect of a variable pulse width Nd:YAG laser combined with hematoporphyrin monomethyl ether (HMME)-mediated photodynamic therapy (PDT) on a cockscomb model of NF. Forty-two leghorn roosters were randomly divided into the following 7 groups: group A1 (treated with HMME-mediated PDT; energy density of 75 J/cm2), group A2 (treated with HMME-mediated PDT; 125 J/cm2), group A3 (treated with HMME-mediated PDT; 150 J/cm2), group A4 (treated with HMME-mediated PDT; 175 J/cm2), group B (treated with a variable pulse width Nd:YAG laser), group C (treated with a variable pulse width Nd:YAG laser and HMME-mediated PDT), and group D (the control group). Changes in the cockscomb tissues were observed visually and microscopically on days 1, 3, 7, and 14 after treatment. The capillary reduction and the ratio of collagen type I to type III were examined. The response rate was higher in groups A3 and A4 than in group B. In group A, a higher energy density resulted in a higher response rate and a greater capillary reduction (p < 0.05 for all). However, we concluded that PDT at an energy density of 175 J/cm2 is not suitable for treating NF, as severe tissue damage, markedly lower capillary numbers, and markedly higher collagen type I:III ratios were observed in the cockscombs treated at this energy density; instead, 150 J/cm2 may be a more appropriate energy density. Moreover, HMME-mediated PDT at 150 J/cm2 combined with a variable pulse width Nd:YAG laser achieved better treatment outcomes than PDT or a variable pulse width Nd:YAG laser alone (p < 0.05 for both). Compared to PDT or a variable pulse width Nd:YAG laser alone, the combination of the 2 therapies achieved a better acute effect in treating a cockscomb model of NF, and 150 J/cm2 may be a suitable energy density for PDT.
Highlights
Nevus flammeus (NF), known as port-wine stain, is a congenital vascular malformation characterized by ectasia of capillaries and venules; it often occurs in dermal papillary and reticular layers.[1,2] The disease does not resolve without treatment, and the incidence rate is about 0.4% in children.[3,4] Treatment options for NF include laser therapy, cryotherapy and surgery.[5–7] A pulsed dye laser, which is the most widely used therapy for NF, can achieve good results but may cause irreversible vessel injury, thereby increasing the risk of purpura
To investigate the acute effect of a variable pulse width Nd:YAG laser combined with hematoporphyrin monomethyl ether (HMME)-mediated photodynamic therapy (PDT) on a cockscomb model of NF
We concluded that PDT at an energy density of 175 J/cm[2] is not suitable for treating NF, as severe tissue damage, markedly lower capillary numbers, and markedly higher collagen type I:III ratios were observed in the cockscombs treated at this energy density; instead, 150 J/cm[2] may be a more appropriate energy density
Summary
Nevus flammeus (NF), known as port-wine stain, is a congenital vascular malformation characterized by ectasia of capillaries and venules; it often occurs in dermal papillary and reticular layers.[1,2] The disease does not resolve without treatment, and the incidence rate is about 0.4% in children.[3,4] Treatment options for NF include laser therapy, cryotherapy and surgery.[5–7] A pulsed dye laser, which is the most widely used therapy for NF, can achieve good results but may cause irreversible vessel injury, thereby increasing the risk of purpura. Nevus flammeus (NF), known as port-wine stain, is a congenital vascular malformation characterized by ectasia of capillaries and venules; it often occurs in dermal papillary and reticular layers.[1,2]. The disease does not resolve without treatment, and the incidence rate is about 0.4% in children.[3,4]. Treatment options for NF include laser therapy, cryotherapy and surgery.[5–7]. A pulsed dye laser, which is the most widely used therapy for NF, can achieve good results but may cause irreversible vessel injury, thereby increasing the risk of purpura. There may be a recurrence after pulsed dye laser therapy, and it is ineffective in some NF cases.[7,8]. It is essential to find a more effective method for the treatment of NF. Nevus flammeus (NF) is a congenital vascular malformation
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