Abstract
Previous in vitro studies demonstrated the potential utility of benzoporphyrin derivative monoacid ring A (BPD) photodynamic therapy (PDT) for vascular destruction. Moreover, the effects of PDT were enhanced when this intervention was followed immediately by pulsed dye laser (PDL) irradiation (PDT/PDL). We further evaluate vascular effects of PDT alone, PDL alone and PDT/PDL in an in vivo rodent dorsal skinfold model. A dorsal skinfold window chamber was installed surgically on female Sprague-Dawley rats. One milligram per kilogram of BPD solution was administered intravenously via a jugular venous catheter. Evaluated interventions were: control (no BPD, no light), PDT alone (576 nm, 16 minutes exposure time, 15 minutes post-BPD injection, 10 mm spot), PDL alone at 7 J/cm2 (585 nm, 1.5 ms pulse duration, 7 mm spot), PDL alone at 10 J/cm2, PDT/PDL (PDL at 7 J/cm2), and PDT/PDL (PDL at 10 J/cm2). To assess changes in microvascular blood flow, laser speckle imaging was performed before, immediately after, and 18 hours post-intervention. Epidermal irradiation was accomplished without blistering, scabbing or ulceration. A reduction in perfusion was achieved in all intervention groups. PDT/PDL at 7 J/cm2 resulted in the greatest reduction in vascular perfusion (56%). BPD PDT can achieve safe and selective vascular flow reduction. PDT/PDL can enhance diminution of microvascular blood flow. Our results suggest that PDT and PDT/PDL should be evaluated as alternative therapeutic options for treatment of hypervascular skin lesions including port wine stain birthmarks.
Highlights
The pulsed dye laser (PDL) is the device of choice for treating cutaneous vascular lesions, achieving impressive results with facial telangiectasia [1]
Following epidermal irradiation up to 18 hours postintervention, we found no clinically relevant skin changes with any of the animals
With photodynamic therapy (PDT) alone (Table 2, Fig. 2), we observed an initial increase (þ17%; paired t-test, P 1⁄4 0.21) in speckle flow index (SFI) followed by a decrease (À19%, paired t-test, P 1⁄4 0.35) in SFI at 18 hours post-intervention
Summary
The pulsed dye laser (PDL) is the device of choice for treating cutaneous vascular lesions, achieving impressive results with facial telangiectasia [1]. As we currently do not have an established noninvasive method for accurate determination of vessel size and depth, laser parameters are selected by the clinician based on limited subjective information and as such are generally not optimized. The effects of PDT were enhanced when this intervention was followed immediately by pulsed dye laser (PDL) irradiation (PDT/ PDL). PDT/PDL at 7 J/ cm resulted in the greatest reduction in vascular perfusion (56%). Conclusions: BPD PDT can achieve safe and selective vascular flow reduction. Our results suggest that PDT and PDT/PDL should be evaluated as alternative therapeutic options for treatment of hypervascular skin lesions including port wine stain birthmarks.
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