Ultrasound investigation of port wine stains

Congenital capillary malformation, or port wine stains (PWS), have been treated with the pulsed dye laser since the late 1980s. Some studies have shown better results when the malformation has been located on the lateral face, forehead, neck, trunk or shoulder and inferior results, with more treatments required, when it is located on the central face area, dermatome V2 or the extremities. The purpose of this study was to determine the depth of the lesion in various locations. A total of 55 patients with untreated PWS were investigated with a high-resolution 20 MHz ultrasound system. The mean maximum depth of all PWS that were measurable (45 out of 55) was 1.00 mm (+/- 0.50 SD), with a range of 0.2-3.7 mm. Lesions located on the forehead (1.26 +/- 0.44 mm) and on the medial face (1.23 +/- 0.65 mm), were deeper than lesions on the trunk and extremities. PWS involving areas that respond poorly to treatment were on average 0.14 mm deeper than PWS involving areas that responded well. The depth of the PWS, as determined with high-resolution ultrasound, seems to correlate only to some degree with the response to pulsed dye laser treatment. Since this treatment, with its superficial penetration, cannot reach the deeper vessels of a PWS, skin ultrasound could be a good complement in the prognostic investigation as well as for planning treatment.