The Diagnosis and Treatment Technology of Port-Wine Stain, and the Prospect of Future Treatment.

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Abstract

Port-wine stain (PWS) is a congenital capillary malformation with a 0.3-0.5% prevalence. This article reviews key techniques and advancements in the diagnosis and treatment of PWS. For assessment, several noninvasive diagnostic techniques were analyzed, including dermoscopy, high-frequency ultrasound, photoacoustic imaging, optical coherence tomography (OCT), laser speckle contrast imaging, the VISIA-CR™ system, and reflectance confocal microscopy. These methods were evaluated on the basis of factors such as vascular morphology (e.g., point, spherical, linear, grid vessels, vessel diameter, vessel wall thickness, etc.), depth of penetration, real-time blood flow monitoring, and quantitative analysis of hemoglobin. However, these noninvasive diagnostic methods share common limitations, such as restricted penetration depth, varying operator dependency, challenges in real-time quantitative analysis, and subjective interpretation in some modalities. In terms of treatment, pulsed dye laser (PDL) therapy remains the clinical gold standard for managing PWS. However, there are now additional options available, including alexandrite laser (755 nm), neodymium-doped yttrium aluminum garnet laser (1064 nm Nd:YAG), and intense pulsed light (IPL), and various other treatment strategies that cater to different characteristics of PWS. Nonetheless, efficacy can be limited by the depth of the blood vessels and individual variability. Photodynamic therapy, which targets the vascular endothelium using photosensitizers, is more effective but also more expensive. Recently, the incorporation of artificial intelligence and deep learning technology holds promise for improving the accuracy of diagnosis and personalization of PWS treatment. This represents a significant direction for future development in this field.

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