Port-wine stain(PWS)is a congenital capillary malformation that occurs in 0.3%–0.5%of newborns.The pulsed dye laser is the current gold standard treatment for PWS;however,its efficacy is poor.Photosensitizer photodyn...Port-wine stain(PWS)is a congenital capillary malformation that occurs in 0.3%–0.5%of newborns.The pulsed dye laser is the current gold standard treatment for PWS;however,its efficacy is poor.Photosensitizer photodynamic therapy(PDT)is considered a promising treatment for PWS.Here we provide a comprehensive overview of PDT.展开更多
Background:The treatment of port-wine stains(PWS)becomes extremely difficult due to age-related malformation of the vasculature.In this study,we used alternative methods to treat hypertrophic PWS.Methods:A short-pulse...Background:The treatment of port-wine stains(PWS)becomes extremely difficult due to age-related malformation of the vasculature.In this study,we used alternative methods to treat hypertrophic PWS.Methods:A short-pulsed CO_(2) laser was applied to ablate the hypertrophic vasculature of PWS.The ablation was ended when the wound was on the same plane as normal skin.The long-pulsed neodymium-doped yttriumaluminum-garnet(lpNd:YAG)laser was primarily applied to coagulate and subsequently liquefy the hypertrophic vasculature of the PWS.The therapeutic energy used in treating different lesions should be carefully regulated to significantly affect the treatment outcomes.Results:The two cases presented herein demonstrated substantial improvement in hypertrophic vasculature that was largely removed.The skin was resurfaced,although some scar formation and mild hypopigmentation occurred.Conclusion:We suggest the use of short-pulsed CO_(2) and lpNd:YAG lasers for treating certain cases of hypertrophic PWS.When using a short-pulsed CO_(2) laser,it is wise to judge the treatment endpoint and take appropriate precautions to avoid intraoperative bleeding.When using an lpNd:YAG laser,the therapeutic energy should be controlled according to the thickness of the lesion to reduce scar formation.展开更多
Background:Port-wine stain(PWS)has been classified not as the hyperplasia of cells,but rather,as an expansion of malformed vessels.However,previous studies have reported upregulated expression of proangiogenic factors...Background:Port-wine stain(PWS)has been classified not as the hyperplasia of cells,but rather,as an expansion of malformed vessels.However,previous studies have reported upregulated expression of proangiogenic factors in PWS.Several studies have indicated that the pathology exhibits proliferation of numerous endothelial cells in hypertrophic/nodular PWS.This study aimed to determine the expression of vascular epithelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9),angiopoietin-2(ANG-2),and basic fibroblast growth factor(bFGF)in hypertrophic PWS.Methods:Immunohistochemistry was used to analyze skin samples from 33 patients with hypertrophic PWS.Expression levels of VEGF,MMP-9,ANG-2,and bFGF in hypertrophic PWS were determined by multiplying the intensity by the percentage of immunoreactive cells.Immunoreactivity scores were classified as follows:negative(0),low(1),moderate(2,3,and 4),or high(6).Results:Based on pathological characteristics,hypertrophic PWS was divided into vascular malformation and pyogenic granuloma(PG)types.VEGF,MMP-9,ANG-2,and bFGF were significantly activated in the blood vessels of PG-type PWS samples compared with their counterparts in blood vessels of vascular malformation-type PWS samples and controls.PG-type hypertrophic PWS,which exhibited proliferation of endothelial cells,showed the strongest activation.Conclusion:The exuberant proliferation of endothelial cells in PG-type hypertrophic PWS may be associated with the regulation of proangiogenic factors during development.These proangiogenic factors that function in the angiogenesis and proliferation of endothelial cells may play an important role in the pathogenesis and progression of PWS.Furthermore,these factors may be dynamic and behave differently in various types of hypertrophic PWS.展开更多
Background：The location of facial port-wine stain （PWS） may be helpful for predicting some associated anomalies;high glaucoma incidence is found in patients with eyes close to PWS-affected areas （V1,ophthalmic bra...Background：The location of facial port-wine stain （PWS） may be helpful for predicting some associated anomalies;high glaucoma incidence is found in patients with eyes close to PWS-affected areas （V1,ophthalmic branch area of the trigeminal nerve）.This study aimed to investigate the characteristics of glaucoma in V1-affected PWS.Methods：A total of 569 patients with V1 area-affected PWS were reviewed in the study.The large series was based on the referral system between the Department of Plastic and Reconstructive Surgery and the Department of Ophthalmology.All patients were screened for glaucoma with assessments of intraocular pressure,cup-to-disc ratio,comeal diameter （only for infants）,and axial length.Results：Of the 569 patients,110 （19.3%） patients had glaucoma.Among the patients,18.1% （76/420） had early-onset glaucoma （under 4-year-old group）.In the 4 to 18-year-old age group,29.3% （29/99） of the patients had glaucoma.Compared with right lateral and bilateral PWS,left-sided PWS had a lower risk of glaucoma in this study （odds ratio =0.432 [95% confidence interval,0.264-0.706],P =0.01）.The under 4-year-old group showed a slight predominance of males （61.8%） in glaucoma.Conclusions：High glaucoma incidence was observed in patients with eyes close to PWS.More attention should be paid to glaucoma screening for right lateral and bilateral PWS patients.The predominance of males in Sturge-Weber syndrome （SWS） early-onset glaucoma patients might be due to the limitation of the case number;however,it might also provide us a new clue of potential relationship between SWS and PCG.展开更多
基金the National Natural Science Foundation of China(grant no.81971847)Interdisciplinary Program of Shanghai Jiao Tong University(grant no.YG2019QNB10)+1 种基金Shanghai Municipal Key Clinical Specialty(grant no.shslczdzk00901)Shanghai Municipal Commission of Health and Family Planning(grant no.202240150)。
文摘Port-wine stain(PWS)is a congenital capillary malformation that occurs in 0.3%–0.5%of newborns.The pulsed dye laser is the current gold standard treatment for PWS;however,its efficacy is poor.Photosensitizer photodynamic therapy(PDT)is considered a promising treatment for PWS.Here we provide a comprehensive overview of PDT.
文摘Background:The treatment of port-wine stains(PWS)becomes extremely difficult due to age-related malformation of the vasculature.In this study,we used alternative methods to treat hypertrophic PWS.Methods:A short-pulsed CO_(2) laser was applied to ablate the hypertrophic vasculature of PWS.The ablation was ended when the wound was on the same plane as normal skin.The long-pulsed neodymium-doped yttriumaluminum-garnet(lpNd:YAG)laser was primarily applied to coagulate and subsequently liquefy the hypertrophic vasculature of the PWS.The therapeutic energy used in treating different lesions should be carefully regulated to significantly affect the treatment outcomes.Results:The two cases presented herein demonstrated substantial improvement in hypertrophic vasculature that was largely removed.The skin was resurfaced,although some scar formation and mild hypopigmentation occurred.Conclusion:We suggest the use of short-pulsed CO_(2) and lpNd:YAG lasers for treating certain cases of hypertrophic PWS.When using a short-pulsed CO_(2) laser,it is wise to judge the treatment endpoint and take appropriate precautions to avoid intraoperative bleeding.When using an lpNd:YAG laser,the therapeutic energy should be controlled according to the thickness of the lesion to reduce scar formation.
基金the National Natural Science Foundation of China(grant no.81602777).
文摘Background:Port-wine stain(PWS)has been classified not as the hyperplasia of cells,but rather,as an expansion of malformed vessels.However,previous studies have reported upregulated expression of proangiogenic factors in PWS.Several studies have indicated that the pathology exhibits proliferation of numerous endothelial cells in hypertrophic/nodular PWS.This study aimed to determine the expression of vascular epithelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9),angiopoietin-2(ANG-2),and basic fibroblast growth factor(bFGF)in hypertrophic PWS.Methods:Immunohistochemistry was used to analyze skin samples from 33 patients with hypertrophic PWS.Expression levels of VEGF,MMP-9,ANG-2,and bFGF in hypertrophic PWS were determined by multiplying the intensity by the percentage of immunoreactive cells.Immunoreactivity scores were classified as follows:negative(0),low(1),moderate(2,3,and 4),or high(6).Results:Based on pathological characteristics,hypertrophic PWS was divided into vascular malformation and pyogenic granuloma(PG)types.VEGF,MMP-9,ANG-2,and bFGF were significantly activated in the blood vessels of PG-type PWS samples compared with their counterparts in blood vessels of vascular malformation-type PWS samples and controls.PG-type hypertrophic PWS,which exhibited proliferation of endothelial cells,showed the strongest activation.Conclusion:The exuberant proliferation of endothelial cells in PG-type hypertrophic PWS may be associated with the regulation of proangiogenic factors during development.These proangiogenic factors that function in the angiogenesis and proliferation of endothelial cells may play an important role in the pathogenesis and progression of PWS.Furthermore,these factors may be dynamic and behave differently in various types of hypertrophic PWS.
基金This study was supported by grants from the National Natural Science Foundation （No. 81670845） and the Research Foundation of Shanghai Science and Technology Committee （No. 14411960600）.
文摘Background：The location of facial port-wine stain （PWS） may be helpful for predicting some associated anomalies;high glaucoma incidence is found in patients with eyes close to PWS-affected areas （V1,ophthalmic branch area of the trigeminal nerve）.This study aimed to investigate the characteristics of glaucoma in V1-affected PWS.Methods：A total of 569 patients with V1 area-affected PWS were reviewed in the study.The large series was based on the referral system between the Department of Plastic and Reconstructive Surgery and the Department of Ophthalmology.All patients were screened for glaucoma with assessments of intraocular pressure,cup-to-disc ratio,comeal diameter （only for infants）,and axial length.Results：Of the 569 patients,110 （19.3%） patients had glaucoma.Among the patients,18.1% （76/420） had early-onset glaucoma （under 4-year-old group）.In the 4 to 18-year-old age group,29.3% （29/99） of the patients had glaucoma.Compared with right lateral and bilateral PWS,left-sided PWS had a lower risk of glaucoma in this study （odds ratio =0.432 [95% confidence interval,0.264-0.706],P =0.01）.The under 4-year-old group showed a slight predominance of males （61.8%） in glaucoma.Conclusions：High glaucoma incidence was observed in patients with eyes close to PWS.More attention should be paid to glaucoma screening for right lateral and bilateral PWS patients.The predominance of males in Sturge-Weber syndrome （SWS） early-onset glaucoma patients might be due to the limitation of the case number;however,it might also provide us a new clue of potential relationship between SWS and PCG.
