Laser and IPL treatment of port-wine stains: Therapy options, limitations, and practical aspects

Lasers in Medical Science

Volumn 26, Issue 6, 2011, Pages 845-859

  Klein, Annette ^a   Bäumler, Wolfgang ^a   Landthaler, Michael ^a   Babilas, Philipp ^a  

^a UNIVERSITY HOSPITAL REGENSBURG   (Germany)

Author keywords

Intense pulsed light; Laser; Light source; Port wine stain; Skin

Indexed keywords

AMINOLEVULINIC ACID; EMLA; PORPHYRIN; VERTEPORFIN;

ALEXANDRITE LASER; ARGON LASER; ARTICLE; CARBON DIOXIDE LASER; CLINICAL FEATURE; DIODE LASER; HUMAN; INFORMED CONSENT; INTENSE PULSED LIGHT; LASER; LIGHT ABSORPTION; LOW LEVEL LASER THERAPY; MEDICAL INFORMATION; NEODYMIUM LASER; NEVUS FLAMMEUS; PHOTOTHERAPY; POTASSIUM TITANYLPHOSPHATE LASER; PRIORITY JOURNAL; PULSED DYE LASER; RANDOMIZED CONTROLLED TRIAL (TOPIC); RECURRENT DISEASE; SKIN MANIFESTATION; SOCIAL PSYCHOLOGY; TREATMENT OUTCOME;

HUMANS; LASER THERAPY, LOW-LEVEL; PHOTOCHEMOTHERAPY; PHOTOTHERAPY; PORT-WINE STAIN; RECURRENCE; TREATMENT OUTCOME;

EID: 83255175610     PISSN: 02688921     EISSN: 1435604X     Source Type: Journal    
DOI: 10.1007/s10103-011-0903-4     Document Type: Article

References (89)

1. Alper JC, Holmes LB (1983) The incidence and significance of birthmarks in a cohort of 4,641 newborns. Pediatr Dermatol 1 (1):58-68 (Pubitemid 14152412)
2. Orten SS, Waner M, Flock S, Roberson PK, Kincannon J (1996) Port-wine stains. An assessment of 5 years of treatment. Arch Otolaryngol Head Neck Surg 122(11):1174-1179
3. Viator JA, Au G, Paltauf G, Jacques SL, Prahl SA, Ren H, Chen Z, Nelson JS (2002) Clinical testing of a photoacoustic probe for port-wine stain depth determination. Lasers Surg Med 30(2):141-148. doi:10.1002/lsm.10015 (Pubitemid 34171201)
4. Shafirstein G, Baumler W, Lapidoth M, Ferguson S, North PE, Waner M (2004) A new mathematical approach to the diffusion approximation theory for selective photothermolysis modeling and its implication in laser treatment of port-wine stains. Lasers Surg Med 34(4):335-347. doi:10.1002/lsm.20028 (Pubitemid 38496136)
5. Fiskerstrand EJ, Svaasand LO, Kopstad G, Ryggen K, Aase S (1996) Photothermally induced vessel-wall necrosis after pulsed dye laser treatment: lack of response in port-wine stains with small sized or deeply located vessels. J Invest Dermatol 107 (5):671-675. doi:0022202X96840486 (Pubitemid 26371079)
6. Smoller BR, Rosen S (1986) Port-wine stains. A disease of altered neural modulation of blood vessels? Arch Dermatol 122(2):177-179 (Pubitemid 16130353)
7. Rosen S, Smoller BR (1987) Port-wine stains: a new hypothesis. J Am Acad Dermatol 17(1):164-166 (Pubitemid 17087217)
8. Revencu N, Boon LM, Mulliken JB, Enjolras O, Cordisco MR, Burrows PE, Clapuyt P, Hammer F, Dubois J, Baselga E, Brancati F, Carder R, Quintal JM, Dallapiccola B, Fischer G, Frieden IJ, Garzon M, Harper J, Johnson-Patel J, Labreze C, Martorell L, Paltiel HJ, Pohl A, Prendiville J, Quere I, Siegel DH, Valente EM, Van Hagen A, Van Hest L, Vaux KK, Vicente A, Weibel L, Chitayat D, Vikkula M (2008) Parkes Weber syndrome, vein of Galen aneurysmal malformation, and other fast-flow vascular anomalies are caused by RASA1 mutations. Hum Mutat 29 (7):959-965. doi:10.1002/humu.20746 (Pubitemid 351951290)
9. Boon LM, Mulliken JB, Vikkula M (2005) RASA1: variable phenotype with capillary and arteriovenous malformations. Curr Opin Genet Dev 15(3):265-269. doi:10.1016/j.gde.2005.03.004 (Pubitemid 40726049)
10. Hershkovitz D, Bercovich D, Sprecher E, Lapidoth M (2008) RASA1 mutations may cause hereditary capillary malformations without arteriovenous malformations. Br J Dermatol 158(5):1035-1040. doi:10.1111/j.1365-2133.2008. 08493.x (Pubitemid 351521454)
11. Vural E, Ramakrishnan J, Cetin N, Buckmiller L, Suen JY, Fan CY (2008) The expression of vascular endothelial growth factor and its receptors in port-wine stains. Otolaryngol Head Neck Surg 139(4):560-564. doi:10.1016/j.otohns.2008.07.015
12. Sanchez-Carpintero I, Mihm MC, Mizeracki A, Waner M, North PE (2004) Epithelial and mesenchymal hamartomatous changes in a mature port-wine stain: morphologic evidence for a multiple germ layer field defect. J Am Acad Dermatol 50(4):608-612. doi:10.1016/j.jaad.2003.04.002 (Pubitemid 38393172)
13. Anderson RR, Parrish JA (1983) Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 220(4596):524-527 (Pubitemid 13114117)
14. Garden JM, Polla LL, Tan OT (1988) The treatment of port-wine stains by the pulsed dye laser. Analysis of pulse duration and long-term therapy. Arch Dermatol 124(6):889-896
15. Taieb A, Touati L, Cony M, Leaute-Labreze C, Mortureux P, Renaud P, Boineau D, Maleville J (1994) Treatment of portwine stains with the 585-nm flashlamp-pulsed tunable dye laser: a study of 74 patients. Dermatology 188(4):276-281 (Pubitemid 24105482)
16. Wlotzke U, Hohenleutner U, Abd-El-Raheem TA, Baumler W, Landthaler M (1996) Side-effects and complications of flashlamp-pumped pulsed dye laser therapy of port-wine stains. A prospective study. Br J Dermatol 134(3):475-480 (Pubitemid 26090942)
17. Zenzie HH, Altshuler GB, Smirnov MZ, Anderson RR (2000) Evaluation of cooling methods for laser dermatology. Lasers Surg Med 26(2):130-144. doi:10.1002/(SICI)1096-9101 (Pubitemid 30118373)
18. Scherer K, Lorenz S, Wimmershoff M, Landthaler M, Hohenleutner U (2001) Both the flashlamp-pumped dye laser and the long-pulsed tunable dye laser can improve results in port-wine stain therapy. Br J Dermatol 145(1):79-84 (Pubitemid 32862790)
19. Renfro L, Geronemus RG (1993) Anatomical differences of port-wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 129(2):182-188 (Pubitemid 23063870)
20. Silapunt S, Goldberg LH, Thurber M, Friedman PM (2004) Basal cell carcinoma arising in a port-wine stain. Dermatol Surg 30 (9):1241-1245. doi:10.1111/j.1524-4725.2004.30384.x (Pubitemid 39312252)
21. del Pozo J, Fonseca E (2001) Port-wine stain nodules in the adult: report of 20 cases treated by CO2 laser vaporization. Dermatol Surg 27(8):699-702 (Pubitemid 32738237)
22. Minkis K, Geronemus RG, Hale EK (2009) Port-wine stain progression: a potential consequence of delayed and inadequate treatment? Lasers Surg Med 41(6):423-426. doi:10.1002/ lsm.20788
23. Kavak A, Alper M, Aydogan I (2007) Port-wine stain, laser therapy and pregnancy: risk factors for multiple pyogenic granulomas? J Eur Acad Dermatol Venereol 21(7):1003-1004. doi:10.1111/j.1468-3083.2007.02076.x (Pubitemid 47103749)
24. Sheehan DJ, Lesher JL Jr (2004) Pyogenic granuloma arising within a port-wine stain. Cutis 73(3):175-180 (Pubitemid 38453135)
25. Sidwell RU, Syed S, Harper JI (2001) Port-wine stains and eczema. Br J Dermatol 144(6):1269-1270
26. Schiffner R, Brunnberg S, Hohenleutner U, Stolz W, Landthaler M (2002) Willingness to pay and time trade-off: useful utility indicators for the assessment of quality of life and patient satisfaction in patients with port-wine stains. Br J Dermatol 146 (3):440-447 (Pubitemid 34603816)
27. Troilius A, Wrangsjo B, Ljunggren B (2000) Patients with portwine stains and their psychosocial reactions after photothermolytic treatment. Dermatol Surg 26(3):190-196 (Pubitemid 30146580)
28. Sommer S, Sheehan-Dare RA (2000) Pulsed dye laser treatment of port-wine stains in pigmented skin. J Am Acad Dermatol 42 (4):667-671 (Pubitemid 30479893)
29. Adamic M, Troilius A, Adatto M, Drosner M, Dahmane R (2007) Vascular lasers and IPLS: guidelines for care from the European Society for Laser Dermatology (ESLD). J Cosmet Laser Ther 9 (2):113-124. doi:10.1080/ 14764170701280693 (Pubitemid 46897787)
30. Verkruysse W, Majaron B, Tanenbaum BS, Nelson JS (2000) Optimal cryogen spray cooling parameters for pulsed laser treatment of port-wine stains. Lasers Surg Med 27(2):165-170. doi:10.1002/1096-9101
31. WimmershoffMB,Wenig M, Hohenleutner U, Landthaler M (2001) Treatment of port-wine stains with the flash lamp pumped dye laser. 5 years of clinical experience. Hautarzt 52(11):1011-1015 (Pubitemid 33054697)
32. Namba Y, Mae O, Ao M (2001) The treatment of port-wine stains with a dye laser: a study of 644 patients. Scand J Plast Reconstr Surg Hand Surg 35(2):197-202 (Pubitemid 32641553)
33. Chapas AM, Eickhorst K, Geronemus RG (2007) Efficacy of early treatment of facial port-wine stains in newborns: a review of 49 cases. Lasers Surg Med 39(7):563-568. doi:10.1002/ lsm.20529 (Pubitemid 47502863)
34. Mariwalla K, Dover JS (2005) The use of lasers in the pediatric population. Skin Therapy Lett 10(8):7-9
35. Garden JM (2007) Laser removal of port-wine stains: how close are we? A Commentary. Lasers Surg Med 39(7):569-570. doi:10.1002/lsm.20539 (Pubitemid 47502864)
36. Lanigan S (2009) Reduction of pain in the treatment of vascular lesions with a pulsed dye laser and pneumatic skin flattening. Lasers Med Sci 24(4):617-620. doi:10.1007/s10103-008-0632-5
37. Aguilar G, Svaasand LO, Nelson JS (2005) Effects of hypobaric pressure on human skin: feasibility study for port-wine stain laser therapy (part I). Lasers Surg Med 36(2):124-129. doi:10.1002/ lsm.20140 (Pubitemid 40315484)
38. Tomson N, Lim SP, Abdullah A, Lanigan SW (2006) The treatment of port-wine stains with the pulsed-dye laser at 2-week and 6-week intervals: a comparative study. Br J Dermatol 154 (4):676-679. doi:10.1111/j.1365-2133.2005. 07113.x (Pubitemid 43374093)
39. Pence B, Aybey B, Ergenekon G (2005) Outcomes of 532-nm frequency-doubled Nd:YAG laser use in the treatment of portwine stains. Dermatol Surg 31(5):509-517 (Pubitemid 43073186)
40. Greve B, Raulin C (2004) Prospective study of port-wine stain treatment with dye laser: comparison of two wavelengths (585 nm vs. 595 nm) and two pulse durations (0.5 milliseconds vs. 20 milliseconds). Lasers Surg Med 34(2):168-173. doi:10.1002/ lsm.20003 (Pubitemid 38326362)
41. Chang CJ, Kelly KM, Van Gemert MJ, Nelson JS (2002) Comparing the effectiveness of 585-nm vs 595-nm wavelength pulsed dye laser treatment of port-wine stains in conjunction with cryogen spray cooling. Lasers Surg Med 31(5):352-358. doi:10.1002/lsm.10102 (Pubitemid 36008437)
42. Prahl S (1999) Optical absorption of hemoglobin. http://omlc.ogi.edu/ spectra/hemoglobin/. Accessed 12 December 2010
43. Yung A, Sheehan-Dare R (2005) A comparative study of a 595- nm with a 585-nm pulsed dye laser in refractory port-wine stains. Br J Dermatol 153(3):601-606. doi:10.1111/j.1365- 2133.2005.06707.x (Pubitemid 41248220)
44. Bencini PL (1999) The multilayer technique: a new and fast approach for flashlamp-pumped pulsed (FLPP) dye laser treatment of port-wine stains (preliminary reports). Dermatol Surg 25 (10):786-789 (Pubitemid 29480972)
45. Lorenz S, Brunnberg S, Landthaler M, Hohenleutner U (2001) Regarding the multilayer technique for treatment of PWS. Dermatol Surg 27(1):90 (Pubitemid 32107631)
46. Fitzpatrick RE, Lowe NJ, Goldman MP, Borden H, Behr KL, Ruiz- Esparza J (1994) Flashlamp-pumped pulsed dye laser treatment of port-wine stains. J Dermatol Surg Oncol 20(11):743-748 (Pubitemid 24357084)
47. Yang MU, Yaroslavsky AN, Farinelli WA, Flotte TJ, Rius-Diaz F, Tsao SS, Anderson RR (2005) Long-pulsed neodymium: yttrium-aluminum-garnet laser treatment for port-wine stains. J Am Acad Dermatol 52(3 Pt 1):480-490. doi:10.1016/j. jaad.2004.10.876
48. Alster TS, Tanzi EL (2009) Combined 595-nm and 1,064-nm laser irradiation of recalcitrant and hypertrophic port-wine stains in children and adults. Dermatol Surg 35(6):914-918. doi:10.1111/j.1524-4725.2009.01155.x, discussion 918-919
49. Borges da Costa J, Boixeda P, Moreno C, Santiago J (2009) Treatment of resistant port-wine stains with a pulsed dualwavelength 595- and 1064-nm laser: a histochemical evaluation of the vessel wall destruction and selectivity. Photomed Laser Surg 27(4):599-605. doi:10.1089/pho.2008.2356
50. Civas E, Koc E, Aksoy B, Aksoy HM (2009) Clinical experience in the treatment of different vascular lesions using a neodymiumdoped yttrium aluminum garnet laser. Dermatol Surg 35(12):1933-1941. doi:10.1111/j.1524-4725.2009. 01355.x
51. Kono T, Frederick Groff W, Chan HH, Sakurai H, Yamaki T (2009) Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for hypertrophic port-wine stains on the lips. J Cosmet Laser Ther 11(1):11-13. doi:10.1080/14764170802307940
52. Chowdhury MM, Harris S, Lanigan SW (2001) Potassium titanyl phosphate laser treatment of resistant port-wine stains. Br J Dermatol 144(4):814-817 (Pubitemid 32374786)
53. Woo WK, Jasim ZF, Handley JM (2004) Evaluating the efficacy of treatment of resistant port-wine stains with variable-pulse 595-nm pulsed dye and 532-nm Nd:YAG lasers. Dermatol Surg 30(2 Pt 1):158-162, discussion 162 (Pubitemid 38314003)
54. Lorenz S, Scherer K, Wimmershoff MB, Landthaler M, Hohenleutner U (2003) Variable pulse frequency-doubled Nd: YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port-wine stains. Acta Derm Venereol 83(3):210-213. doi:10.1080/00015550310007238 (Pubitemid 36629827)
55. Izikson L, Nelson JS, Anderson RR (2009) Treatment of hypertrophic and resistant port-wine stains with a 755 nm laser: a case series of 20 patients. Lasers Surg Med 41(6):427-432. doi:10.1002/lsm.20793
56. McGill DJ, MacLaren W, Mackay IR (2008) A direct comparison of pulsed dye, alexandrite, KTP and Nd:YAG lasers and IPL in patients with previously treated capillary malformations. Lasers Surg Med 40(6):390-398. doi:10.1002/lsm.20638
57. Dover JS, Arndt KA (2000) New approaches to the treatment of vascular lesions. Lasers Surg Med 26(2):158-163. doi:10.1002/ (SICI)1096-9101 (Pubitemid 30118375)
58. Whang KK, Byun JY, Kim SH (2009) A dual-wavelength approach with 585-nm pulsed-dye laser and 800-nm diode laser for treatment-resistant port-wine stains. Clin Exp Dermatol 34(7): e436-e437. doi:10.1111/j.1365-2230.2009.03454.x
59. Tierney EP, Hanke CW (2009) Treatment of nodules associated with port-wine stains with CO2 laser: case series and review of the literature. J Drugs Dermatol 8(2):157-161
60. Babilas P, Schreml S, Eames T, Hohenleutner U, Szeimies RM, Landthaler M (2010) Split-face comparison of intense pulsed light with short- and long-pulsed dye lasers for the treatment of portwine stains. Lasers Surg Med 42(8):720-727. doi:10.1002/ lsm.20964
61. Faurschou A, Togsverd-Bo K, Zachariae C, Haedersdal M (2009) Pulsed dye laser vs. intense pulsed light for port-wine stains: a randomized side-by-side trial with blinded response evaluation. Br J Dermatol 160(2):359-364. doi:10.1111/j.1365-2133.2008.08993.x
62. Reynolds N, Exley J, Hills S, Falder S, Duff C, Kenealy J (2005) The role of the Lumina intense pulsed light system in the treatment of port-wine stains-a case controlled study. Br J Plast Surg 58(7):968-980. doi:10.1016/j.bjps.2005.04.006 (Pubitemid 41403689)
63. Ho WS, Ying SY, Chan PC, Chan HH (2004) Treatment of portwine stains with intense pulsed light: a prospective study. Dermatol Surg 30(6):887-890. doi:10.1111/ j .1524- 4725.2004.30260.x, discussion 890-881
64. Evans AV, Robson A, Barlow RJ, Kurwa HA (2005) Treatment of port-wine stains with photodynamic therapy, using pulsed dye laser as a light source, compared with pulsed dye laser alone: a pilot study. Lasers Surg Med 36(4):266-269. doi:10.1002/lsm.20151 (Pubitemid 40578018)
65. Tournas JA, Lai J, Truitt A, Huang YC, Osann KE, Choi B, Kelly KM (2009) Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port-wine stain birthmarks. Photodiagnosis Photodyn Ther 6(3-4):195-199. doi:10.1016/j.pdpdt.2009.10.002
66. Qin ZP, Li KL, Ren L, Liu XJ (2007) Photodynamic therapy of port-wine stains-a report of 238 cases. Photodiagn Photodyn Ther 4(1):53-59. doi:10.1016/j.pdpdt.2007.01.001 (Pubitemid 46274568)
67. Wareham WJ, Cole RP, Royston SL, Wright PA (2009) Adverse effects reported in pulsed dye laser treatment for port-wine stains. Lasers Med Sci 24(2):241-246. doi:10.1007/s10103-008-0560-4
68. Sommer S, Seukeran DC, Sheehan-Dare RA (2003) Efficacy of pulsed dye laser treatment of port-wine stain malformations of the lower limb. Br J Dermatol 149(4):770-775 (Pubitemid 37411997)
69. Owens WW 3rd, Lang PG (2004) Herpes simplex infection and colonization with Pseudomonas aeruginosa complicating pulseddye laser treatment. Arch Dermatol 140(6):760-761. doi:10.1001/ archderm.140.6.760 (Pubitemid 38747303)
70. Chen T, Frieden IJ (2007) Development of extensive flat warts after pulsed dye laser treatment of a port-wine stain. Dermatol Surg 33(6):734-735. doi:10.1111/j.1524-4725.2007.33152.x (Pubitemid 46855054)
71. Woo WK, Handley JM (2003) Does fluence matter in the laser treatment of port-wine stains? Clin Exp Dermatol 28(5):556-557 (Pubitemid 37100567)
72. Liu H, Dang Y, Chai X, Wang Z, Ma L, Ren Q (2007) Treatment of port-wine stains with the 595-nm pulsed dye laser: a pilot study in Chinese patients. Clin Exp Dermatol 32(6):646-649. doi:10.1111/j.1365-2230.2007.02517.x (Pubitemid 47609759)
73. Hennedige AA, Quaba AA, Al-Nakib K (2008) Sturge-Weber syndrome and dermatomal facial port-wine stains: incidence, association with glaucoma, and pulsed tunable dye laser treatment effectiveness. Plast Reconstr Surg 121(4):1173-1180. doi:10.1097/01.prs.0000304606.33897.71 (Pubitemid 351653212)
74. Nagore E, Requena C, Sevila A, Coll J, Costa D, Botella-Estrada R, Sanmartin O, Serra-Guillen C, Guillen C (2004) Thickness of healthy and affected skin of children with port-wine stains: potential repercussions on response to pulsed dye laser treatment. Dermatol Surg 30(12 Pt 1):1457-1461. doi:10.1111/j.1524- 4725.2004.30503.x (Pubitemid 40053554)
75. Babilas P, Shafirstein G, Baumler W, Baier J, Landthaler M, Szeimies RM, Abels C (2005) Selective photothermolysis of blood vessels following flashlamp-pumped pulsed dye laser irradiation: in vivo results and mathematical modelling are in agreement. J Invest Dermatol 125(2):343-352. doi:10.1111/ j.0022-202X.2005.23773.x (Pubitemid 41648169)
76. Black JF, Barton JK (2004) Chemical and structural changes in blood undergoing laser photocoagulation. Photochem Photobiol 80:89-97. doi:10.1562/2004-03-05-RA-102.1
77. Barsky SH, Rosen S, Geer DE, Noe JM (1980) The nature and evolution of port-wine stains: a computer-assisted study. J Invest Dermatol 74(3):154-157 (Pubitemid 10184146)
78. Michel S, Landthaler M, Hohenleutner U (2000) Recurrence of port-wine stains after treatment with the flashlamp-pumped pulsed dye laser. Br J Dermatol 143(6):1230-1234 (Pubitemid 32052760)
79. Huikeshoven M, Koster PH, de Borgie CA, Beek JF, van Gemert MJ, van der Horst CM (2007) Redarkening of port-wine stains 10 years after pulsed-dye-laser treatment. N Engl J Med 356 (12):1235-1240. doi:10.1056/NEJMoa064329 (Pubitemid 46465599)
80. Hansen K, Kreiter CD, Rosenbaum M, Whitaker DC, Arpey CJ (2003) Long-term psychological impact and perceived efficacy of pulsed-dye laser therapy for patients with port-wine stains. Dermatol Surg 29(1):49-55 (Pubitemid 36114729)
81. Jia W, Sun V, Tran N, Choi B, Liu SW, Mihm MC Jr, Phung TL, Nelson JS (2010) Long-term blood vessel removal with combined laser and topical rapamycin antiangiogenic therapy: implications for effective port-wine stain treatment. Lasers Surg Med 42 (2):105-112. doi:10.1002/lsm.20890
82. Loewe R, Oble DA, Valero T, Zukerberg L, Mihm MC Jr, Nelson JS (2010) Stem cell marker upregulation in normal cutaneous vessels following pulsed-dye laser exposure and its abrogation by concurrent rapamycin administration: implications for treatment of port-wine stain birthmarks. J Cutan Pathol 37(Suppl 1):76-82. doi:10.1111/j.1600-0560.2010.01520.x
83. Phung TL, Oble DA, Jia W, Benjamin LE, Mihm MC Jr, Nelson JS (2008) Can the wound healing response of human skin be modulated after laser treatment and the effects of exposure extended? Implications on the combined use of the pulsed dye laser and a topical angiogenesis inhibitor for treatment of port wine stain birthmarks. Lasers Surg Med 40(1):1-5. doi:10.1002/ lsm.20599 (Pubitemid 351214117)
84. Chang CJ, Hsiao YC, Mihm MC Jr, Nelson JS (2008) Pilot study examining the combined use of pulsed dye laser and topical Imiquimod versus laser alone for treatment of port wine stain birthmarks. Lasers SurgMed 40(9):605-610. doi:10.1002/lsm.20716
85. Asahina A, Watanabe T, Kishi A, Hattori N, Shirai A, Kagami S, Watanabe R, Le Pavoux A, Maekawa T, Tamaki K, Ohara K (2006) Evaluation of the treatment of port-wine stains with the 595-nm long pulsed dye laser: a large prospective study in adult Japanese patients. J Am Acad Dermatol 54(3):487-493. doi:10.1016/j.jaad.2005.11.1034 (Pubitemid 43243453)
86. Bernstein EF (2006) High-energy 595-nm pulsed dye laser improves refractory port-wine stains. Dermatol Surg 32(1):26-33
87. Bernstein EF, Brown DB (2005) Efficacy of the 1.5 millisecond pulse-duration, 585 nm, pulsed-dye laser for treating port-wine stains. Lasers Surg Med 36(5):341-346. doi:10.1002/lsm.20182 (Pubitemid 40942146)
88. Kelly KM, Nanda VS, Nelson JS (2002) Treatment of port-wine stain birthmarks using the 1.5-msec pulsed dye laser at high fluences in conjunction with cryogen spray cooling. Dermatol Surg 28(4):309-313 (Pubitemid 34461424)
89. Geronemus RG, Quintana AT, Lou WW, Kauvar AN (2000) Highfluence modified pulsed dye laser photocoagulation with dynamic cooling of port-wine stains in infancy. Arch Dermatol 136(7):942-943 (Pubitemid 30604305)