{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:32:12Z","timestamp":1781116332203,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T00:00:00Z","timestamp":1563235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Port wine stain (PWS) is a congenital vascular malformation of the human skin. Laser is the treatment of choice for PWS. Laser\u2010resistant PWS is one crucial factor accounting for inadequate treatment outcome, which needs to be fully characterized. This study aims to quantitatively characterize the morphology of laser\u2010resistant PWS blood vessels in the upper papillary dermis using <jats:italic>in vivo<\/jats:italic> reflectance confocal microscopy (RCM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>A total of 42 PWS subjects receiving laser treatment from August 2016 through July 2018 were enrolled into this study. Thirty\u2010three subjects had facial PWS; nine had extremity PWS. All subject's PWS received multiplex 585\/1,064 nm laser treatment. RCM images were taken before and after treatment. The density, diameter, blood flow, and depth of PWS blood vessels were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found 44.4% PWS on the extremities (four out of nine subjects) were laser\u2010resistant, which was significantly higher (<jats:italic>P<\/jats:italic> &lt; 0.001) when compared with those PWS on the face (15.2%, 5 out of 33 subjects). The laser\u2010resistant facial PWS blood vessels had significantly higher blood flow (1.35 \u00b1 0.26 U vs. 0.89 \u00b1 0.22 U, <jats:italic>P<\/jats:italic> &lt; 0.001), larger blood vessel diameters (109.60 \u00b1 18.24 \u00b5m vs. 84.36 \u00b1 24.04 \u00b5m, <jats:italic>P<\/jats:italic> = 0.033) and were located deeper in the skin (106.01 \u00b1 13.87 \u00b5m vs. 87.82 \u00b1 12.57 \u00b5m, <jats:italic>P<\/jats:italic> &lt; 0.001) in the skin when compared with laser\u2010responsive PWS on the face. The average PWS blood vessel density (17.01 \u00b1 4.63\/mm<jats:sup>2<\/jats:sup> vs. 16.61 \u00b1 4.44\/mm<jats:sup>2<\/jats:sup>, <jats:italic>P<\/jats:italic> = 0.857) was not correlated to the laser resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Laser\u2010resistant PWS blood vessels had significantly higher blood flow, larger diameters, and were located deeper in the skin. RCM can be a valuable tool for a prognostic evaluation on laser\u2010resistant lesions before treatment, thereby providing guidance for tailored laser treatment protocols, which may improve the therapeutic outcome. The limitations for this study include relative small sample size and acquisitions of different blood vessels before and after 2 months of treatment. Lasers Surg. Med. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23134","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T12:50:23Z","timestamp":1563281423000},"page":"841-849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Characterization of Laser\u2010Resistant Port Wine Stain Blood Vessels Using <i>In Vivo<\/i> Reflectance Confocal Microscopy"],"prefix":"10.1002","volume":"51","author":[{"given":"Zhibing","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaping","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Stuart","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Beckman Laser Institute and Medical Clinic University of California  Irvine California 92617"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Beckman Laser Institute and Medical Clinic University of California  Irvine California 92617"},{"name":"Department of Cell Biology and Anatomy University of South Carolina School of Medicine  Columbia South Carolina 29208"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyun","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Third Xiangya Hospital Central South University  Changsha Hunan 410013 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,16]]},"reference":[{"key":"e_1_2_6_1_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15716"},{"key":"e_1_2_6_1_3_1","volume-title":"Vascular Birthmarks\u2014Hemangiomas and Malformations","author":"Mulliken JB","year":"1988"},{"key":"e_1_2_6_1_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.58.2.218"},{"key":"e_1_2_6_1_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1953.01540030065006"},{"key":"e_1_2_6_1_6_1","unstructured":"ISSVA. 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