Spectrophotometers for the clinical assessment of port-wine stain skin lesions: a review

Reflectance spectrophotometry is the most established and widely used objective technique for the assessment of port-wine stain (PWS) skin, and has been applied extensively in other dermatological applications. To date, no review has been published regarding the different spectrophotometric devices used on PWS skin. This paper comprises such a review, introducing the reader to the relevant background material and then discussing scanning, narrow-band and tristimulus spectrophotometers in turn. Scanning spectrophotometry is the most versatile of the three methods but it is noted that considerable expertise is required to interpret the acquired data. Narrow-band and tristimulus devices are available at a much lower price and can be considerably simpler to use. They do, however, provide limited information that does not account for the complex effects of melanin and other chromophores within the skin. Although scanning spectrophotometers would be the preferred choice for most investigations, cheaper, simpler and equally reliable options are available and may better suit the needs of some research projects.

[1]  L Wang,et al.  MCML--Monte Carlo modeling of light transport in multi-layered tissues. , 1995, Computer methods and programs in biomedicine.

[2]  R. Knobler,et al.  Photoelectric quantitative evaluation of argon laser treatment of port wine stains , 1991, The British journal of dermatology.

[3]  F. Staes,et al.  Reproducibility of repeated measurements on healthy skin with Minolta Chromameter CR‐300 , 2001, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[4]  Zaid F Jasim,et al.  Treatment of pulsed dye laser-resistant port wine stain birthmarks. , 2007, Journal of the American Academy of Dermatology.

[5]  T. Agner,et al.  Colorimetric quantification of erythema—a comparison of two colorimeters (Lange Micro Color and Minolta Chroma Meter CR‐200) with a clinical scoring scheme and laser‐Doppler flowmetry , 1990, Clinical and experimental dermatology.

[6]  W Verkruysse,et al.  Simulation of color of port wine stain skin and its dependence on skin variables , 1999, Lasers in surgery and medicine.

[7]  M. Shriver,et al.  Comparison of narrow-band reflectance spectroscopy and tristimulus colorimetry for measurements of skin and hair color in persons of different biological ancestry. , 2000, American journal of physical anthropology.

[8]  George Zonios,et al.  Comparative evaluation of two simple diffuse reflectance models for biological tissue applications. , 2008, Applied optics.

[9]  Ewald Hering.  Outlines of a theory of the light sense , 1964 .

[10]  J. Pickering,et al.  The objective reporting of laser treatment of port wine stains , 1992, Lasers in Medical Science.

[11]  G. Piérard,et al.  EEMCO guidance for the assessment of skin colour. , 1998, Journal of the European Academy of Dermatology and Venereology : JEADV.

[12]  R. Botella-Estrada,et al.  Videomicroscopy of Venular Malformations (Port‐Wine Stain Type): Prediction of Response to Pulsed Dye Laser , 2004, Pediatric dermatology.

[13]  B. Wilson,et al.  A diffusion theory model of spatially resolved, steady-state diffuse reflectance for the noninvasive determination of tissue optical properties in vivo. , 1992, Medical physics.

[14]  S. Lanigan,et al.  The treatment of port‐wine stains with the pulsed‐dye laser at 2‐week and 6‐week intervals: a comparative study , 2006, The British journal of dermatology.

[15]  P. Clarys,et al.  Skin color measurements: comparison between three instruments: the Chromameter®, the DermaSpectrometer® and the Mexameter® , 2000, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[16]  I M Braverman,et al.  Ultrastructure and three-dimensional reconstruction of several macular and papular telangiectases. , 1983, The Journal of investigative dermatology.

[17]  G H Findlay.  BLUE SKIN , 1970, The British journal of dermatology.

[18]  E. Claridge,et al.  Spectrophotometric intracutaneous analysis: a new technique for imaging pigmented skin lesions , 2002, The British journal of dermatology.

[19]  L. T. Norvang,et al.  Laser treatment of port wine stains: therapeutic outcome in relation to morphological parameters , 1996, The British journal of dermatology.

[20]  Bernard Choi,et al.  Noninvasive blood flow imaging for real‐time feedback during laser therapy of port wine stain birthmarks , 2008, Lasers in surgery and medicine.

[21]  J. Cotterill,et al.  Reduced vasoactive responses in port wine stains , 1990, The British journal of dermatology.

[22]  K. Wilhelm,et al.  Interlaboratory comparison and validity study of the Minolta ChromaMeters CR‐200 and CR‐300 , 1996, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[23]  R. Barlow,et al.  Objective assessment of port‐wine stains following treatment with the 585 nm pulsed dye laser , 2001, The Australasian journal of dermatology.

[24]  A. Troilius,et al.  Reflectance spectrophotometry in the objective assessment of dye laser‐treated port‐wine stains , 1995, The British journal of dermatology.

[25]  Guillermo Aguilar,et al.  Determination of human skin optical properties from spectrophotometric measurements based on optimization by genetic algorithms. , 2005, Journal of biomedical optics.

[26]  F Bazant-Hegemark,et al.  Optical coherence tomography: a potential tool for unsupervised prediction of treatment response for Port-Wine Stains. , 2008, Photodiagnosis and photodynamic therapy.

[27]  J. Cotterill,et al.  Copper vapour laser treatment of port wine stains: clinical evaluation and comparison with conventional argon laser therapy , 1993, The British journal of dermatology.

[28]  L. Holmes,et al.  The Incidence and Significance of Birthmarks in a Cohort of 4,641 Newborns , 1983, Pediatric dermatology.

[29]  B. Diffey,et al.  A portable instrument for quantifying erythema induced by ultraviolet radiation , 1984, The British journal of dermatology.

[30]  A. Welch,et al.  Modeling laser treatment of port wine stains with a computer‐reconstructed biopsy , 1999, Lasers in surgery and medicine.

[31]  I. A. Niechajev,et al.  Histology of port-wine stain , 1990, European Journal of Plastic Surgery.

[32]  H. Takiwaki,et al.  A case of episodic angioedema associated with eosinophilia. , 1997, The journal of medical investigation : JMI.

[33]  H. Shahidullah,et al.  Review of modern techniques in detecting port-wine stain response to laser therapy. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[34]  P. Bossuyt,et al.  Prediction of portwine stain clearance and required number of flashlamp pumped pulsed dye laser treatments , 2001, Lasers in surgery and medicine.

[35]  A. Welch,et al.  A review of the optical properties of biological tissues , 1990 .

[36]  S. J. Matcher,et al.  Computer simulation of the skin reflectance spectra , 2003, Comput. Methods Programs Biomed..

[37]  Bernard Choi,et al.  Use of erythema index imaging for systematic analysis of port wine stain skin response to laser therapy , 2005, Lasers in surgery and medicine.

[38]  Feifan Zhou,et al.  In vivo photoacoustic imaging of subcutaneous vasculature and vascular anomalies in small animals , 2008 .

[39]  D. J. Ellis,et al.  A theoretical and experimental study of light absorption and scattering by in vivo skin. , 1980, Physics in medicine and biology.

[40]  Noninvasive Blood Flow Imaging for Real-Time Feedback During Laser Therapy of Port Wine Stain Birthmarks , 2008 .

[41]  Daniela Massi,et al.  Application of optical coherence tomography in non‐invasive characterization of skin vascular lesions , 2008, Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging.

[42]  Guy Rotteleur,et al.  Quantitative assessment of port-wine stains using chromametry: preliminary results , 1996, European Conference on Biomedical Optics.

[43]  I. Nishidate,et al.  Estimation of melanin and hemoglobin in skin tissue using multiple regression analysis aided by Monte Carlo simulation. , 2004, Journal of biomedical optics.

[44]  L. T. Norvang,et al.  Laser treatment of port wine stains: a study comparing therapeutic outcome with morphologic characteristics of the lesions. Preliminary results. , 1995, Acta dermato-venereologica.

[45]  Jau-Song Yu,et al.  Confocal microscopy study of neurovascular distribution in facial port wine stains (capillary malformation). , 2008, Journal of the Formosan Medical Association = Taiwan yi zhi.

[46]  J W Pickering,et al.  Modeling the color perception of port wine stains and its relation to the depth of laser coagulated blood vessels , 1993, Lasers in surgery and medicine.

[47]  J. Huff,et al.  Lesion size is a factor for determining the rate of port-wine stain clearing following pulsed dye laser treatment in adults. , 1997, Cutis.

[48]  R. Anderson,et al.  The optics of human skin. , 1981, The Journal of investigative dermatology.

[49]  J Serup,et al.  Comparison of narrow-band reflectance spectrophotometric and tristimulus colorimetric measurements of skin color. Twenty-three anatomical sites evaluated by the Dermaspectrometer and the Chroma Meter CR-200. , 1994, Skin pharmacology : the official journal of the Skin Pharmacology Society.

[50]  J. Laufer,et al.  In vivo high-resolution 3D photoacoustic imaging of superficial vascular anatomy , 2009, Physics in medicine and biology.

[51]  P. Wright,et al.  Construction of a novel port wine stain phantom and measurement of colour by digital imaging and reflectance spectrophotometry , 2008, Lasers in Medical Science.

[52]  P. Spauwen,et al.  Pulsed dye laser treatment, a review of indications and outcome based on published trials. , 2005, British journal of plastic surgery.

[53]  S. Lanigan,et al.  Treatment of resistant port wine stains with the V Beam® pulsed dye laser , 2003, Lasers in surgery and medicine.

[54]  J. Feather,et al.  An investigation of factors affecting the accuracy of in vivo measurements of skin pigments by reflectance spectrophotometry , 1990, Physics in medicine and biology.

[55]  S. Ohmori,et al.  Recent progress in the treatment of portwine staining by argon laser: some observations on the prognostic value of relative spectro-reflectance (RSR) and the histological classification of the lesions. , 1981, British journal of plastic surgery.

[56]  Bernard Choi,et al.  A library based fitting method for visual reflectance spectroscopy of human skin , 2005, Physics in medicine and biology.

[57]  J. Cotterill,et al.  Objective assessments of port wine stains: response to temperature change , 1988, The British journal of dermatology.

[58]  J M Noe,et al.  The nature and evolution of port wine stains: a computer-assisted study. , 1980, The Journal of investigative dermatology.

[59]  Zhongping Chen,et al.  Clinical testing of a photoacoustic probe for port wine stain depth determination , 2002, Lasers in surgery and medicine.

[60]  R Hibst,et al.  A new optimal wavelength for treatment of port wine stains? , 1995, Physics in medicine and biology.

[61]  H. Takiwaki.  Measurement of skin color: practical application and theoretical considerations. , 1998, The journal of medical investigation : JMI.

[62]  A. A. Cox,et al.  Spatial sampling by diffuse photons. , 2001, Applied optics.

[63]  B. S. Tanenbaum,et al.  Non-invasive determination of port wine stain anatomy and physiology for optimal laser treatment strategies. , 1997, Physics in medicine and biology.

[64]  K. Arndt,et al.  In vivo spectrophotometric evaluation of normal, lesional, and laser-treated skin in patients with port-wine stains. , 1983, The Journal of investigative dermatology.

[65]  Lihong V. Wang,et al.  In vivo volumetric imaging of subcutaneous microvasculature by photoacoustic microscopy. , 2006, Optics express.

[66]  B. S. Tanenbaum,et al.  Infra-red tomography of port-wine-stain blood vessels in human skin , 1996, Lasers in Medical Science.

[67]  George E. Brown,et al.  THE SPECTROPHOTOMETRIC ANALYSIS OF THE COLOR OF THE SKIN: AND THE OBSERVATIONS BY THIS METHOD IN NORMAL AND IN PATHOLOGIC SUBJECTS , 1926 .

[68]  Y. Mitsuhashi,et al.  Ultrastructural observations in port wine stains , 2004, Archives of Dermatological Research.

[69]  A. Troilius,et al.  Evaluation of port wine stains by laser Doppler perfusion imaging and reflectance photometry before and after pulsed dye laser treatment. , 1996, Acta dermato-venereologica.

[70]  M. V. van Gemert,et al.  Modelling the assessment of port wine stain parameters from skin surface temperature following a diagnostic laser pulse , 1997, Lasers in surgery and medicine.

[71]  J. Nelson,et al.  Cryogen spray cooling and higher fluence pulsed dye laser treatment improve port-wine stain clearance while minimizing epidermal damage. , 1999, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[72]  Boris Majaron,et al.  Accurate measurement of blood vessel depth in port wine stained human skin in vivo using pulsed photothermal radiometry. , 2004, Journal of biomedical optics.

[73]  Chang-Seok Kim,et al.  Clinical feasibility of various optical instruments for quantitative evaluation of pulsed-dye laser treatment of port wine stain skin , 2005, SPIE BiOS.

[74]  M Itoh,et al.  Melanin and blood concentration in human skin studied by multiple regression analysis: experiments. , 2001, Physics in medicine and biology.

[75]  M. Landthaler,et al.  Correlations Between Light Penetration into Skin and the Therapeutic Outcome Following Laser Therapy of Port-wine Stains , 2002, Lasers in Medical Science.