Research Article| Volume 60, ISSUE 1, P79-86, January 2007

The validation of the Depth Measurement Videomicroscope (DMV) as a noninvasive tool for the assessment of capillary vascular malformations


      The assessment of capillary vascular malformation (CM) morphology can be performed using videomicroscopy. Previously only the type of capillary pattern could be demonstrated. The Depth Measurement Videomicroscope (DMV) allows both depth and diameter of CM vessels to be measured. The aim of this study was to examine how videomicroscope recordings correlated with biopsy recordings and to investigate pressure-related changes in recordings when using the device.
      For the first part of the study, 10 patients with CMs resting in a temperature-controlled room were assessed with the DMV. Following this a 3 mm punch biopsy of the area was taken. The depth and diameter measurements taken with the DMV were compared to those obtained histologically. For the second part of the study, pressure measurement was used to determine the amount of pressure required on the tip of the DMV to alter the results obtained. Five recordings were taken on the forearm of one volunteer.
      When the DMV and biopsy measurements are compared using a Bland and Altman Test to determine their relationship there is a close agreement with the diameter measurements and a correction factor of −0.100 mm for the depth measurements.
      The pressure required to alter the skin microcirculation when placing the DMV on the skin surface was found to be 62 mmHg. This corresponds closely with other studies of pressure effects on the skin microcirculation and exceeds the pressure used when using the DMV. The DMV thus provides a useful tool for assessing CM capillary structure.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mulliken J.B.
        • Glowacki J.
        Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.
        Plast Reconstr Surg. 1982; 69: 412-422
        • Jacobs A.H.
        • Walton R.G.
        The incidence of birthmarks in the neonate.
        Pediatrics. 1976; 58: 218-222
        • Augustin M.
        • Zschocke I.
        • Wiek K.
        • et al.
        Psychosocial stress of patients with port wine stains and expectations of dye laser treatment.
        Dermatology. 1998; 197: 353-360
        • Lanigan S.W.
        • Cotterill J.A.
        Psychological disabilities amongst patients with port wine stains.
        Br J Dermatol. 1989; 121: 209-215
        • Miller A.C.
        • Pit-Ten Cate I.M.
        • Watson H.S.
        • et al.
        Stress and family satisfaction in parents of children with facial port-wine stains.
        Pediatr Dermatol. 1999; 16: 190-197
        • Troilius A.
        • Wrangsjo B.
        • Ljunggren B.
        Potential psychological benefits from early treatment of port-wine stains in children.
        Br J Dermatol. 1998; 139: 59-65
        • Noe J.M.
        • Barsky S.H.
        • Geer D.E.
        • et al.
        Port wine stains and the response to argon laser therapy: successful treatment and the predictive role of color, age, and biopsy.
        Plast Reconstr Surg. 1980; 65: 130-136
        • Alster T.S.
        • Wilson F.
        Treatment of port-wine stains with the flashlamp-pumped pulsed dye laser: extended clinical experience in children and adults.
        Ann Plast Surg. 1994; 32: 478-484
        • Goldman M.P.
        • Fitzpatrick R.E.
        • Ruiz-Esparza J.
        Treatment of port-wine stains (capillary malformation) with the flashlamp-pumped pulsed dye laser.
        J Pediatr. 1993; 122: 71-77
        • Katugampola G.A.
        • Lanigan S.W.
        Five years' experience of treating port wine stains with the flashlamp-pumped pulsed dye laser.
        Br J Dermatol. 1997; 137: 750-754
        • Nelson J.S.
        • Applebaum J.
        Clinical management of port-wine stain in infants and young children using the flashlamp-pulsed dye laser.
        Clin Pediatr (Phila). 1990; 29: 503-508
        • Lanigan S.W.
        Port-wine stains unresponsive to pulsed dye laser: explanations and solutions.
        Br J Dermatol. 1998; 139: 173-177
        • Fiskerstrand E.J.
        • Svaasand L.O.
        • Kopstad G.
        • et al.
        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. 1996; 107: 671-675
        • Hohenleutner U.
        • Hilbert M.
        • Wlotzke U.
        • et al.
        Epidermal damage and limited coagulation depth with the flashlamp-pumped pulsed dye laser: a histochemical study.
        J Invest Dermatol. 1995; 104: 798-802
        • Smithies D.J.
        • Van Gemert M.J.
        • Hansen M.K.
        • et al.
        Three-dimensional reconstruction of port wine stain vascular anatomy from serial histological sections.
        Phys Med Biol. 1997; 42: 1843-1847
        • Trelles M.A.
        • Svaasand L.O.
        • Velez M.
        • et al.
        Possible mechanisms for an irregular vessel coagulation when long laser pulses are used in the treatment of port-wine stains.
        J Dermatol Sci. 1996; 13: 161-166
        • Troilius A.
        • Wardell K.
        • Bornmyr S.
        • et al.
        Evaluation of port wine stain perfusion by laser Doppler imaging and thermography before and after argon laser treatment.
        Acta Derm Venereol. 1992; 72: 6-10
        • Anderson R.R.
        • Parrish J.A.
        Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation.
        Science. 1983; 220: 524-527
        • Garden J.M.
        • Tan O.T.
        • Kerschmann R.
        • et al.
        Effect of dye laser pulse duration on selective cutaneous vascular injury.
        J Invest Dermatol. 1986; 87: 653-657
        • Kimel S.
        • Svaasand L.O.
        • Cao D.
        • et al.
        Vascular response to laser photothermolysis as a function of pulse duration, vessel type, and diameter: implications for port wine stain laser therapy.
        Lasers Surg Med. 2002; 30: 160-169
        • Van Gemert M.J.
        • Nelson J.S.
        • Milner T.E.
        • et al.
        Non-invasive determination of port wine stain anatomy and physiology for optimal laser treatment strategies.
        Phys Med Biol. 1997; 42: 937-950
        • Chang C.J.
        • Kelly K.M.
        • Van Gemert M.J.
        • et al.
        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. 2002; 31: 352-358
        • Edstrom D.W.
        • Ros A.M.
        The treatment of port-wine stains with the pulsed dye laser at 600 nm.
        Br J Dermatol. 1997; 136: 360-363
        • Kimel S.
        • Svaasand L.O.
        • Hammer-Wilson M.J.
        • et al.
        Influence of wavelength on response to laser photothermolysis of blood vessels: implications for port wine stain laser therapy.
        Lasers Surg Med. 2003; 33: 288-295
        • Le K.V.
        • Shahidullah H.
        • Frieden I.J.
        Review of modern techniques in detecting port-wine stain response to laser therapy.
        Dermatol Surg. 1999; 25: 127-132
        • Schubert V.
        • Fagrell B.
        Local skin pressure and its effects on skin microcirculation as evaluated by laser-Doppler fluxmetry.
        Clin Physiol. 1989; 9: 535-545
        • Bland J.M.
        • Altman D.G.
        Statistical methods for assessing agreement between two methods of clinical measurement.
        Lancet. 1986; 1: 307-310
        • Barton J.K.
        • Hammer D.X.
        • Pfefer T.J.
        • et al.
        Simultaneous irradiation and imaging of blood vessels during pulsed laser delivery.
        Lasers Surg Med. 1999; 24: 236-243
        • Kehlet B.J.
        • Izatt J.A.
        • Kulkarni M.D.
        • et al.
        Three-dimensional reconstruction of blood vessels from in vivo color Doppler optical coherence tomography images.
        Dermatology. 1999; 198: 355-361
        • Laube S.
        • Taibjee S.
        • Lanigan S.W.
        Treatment of resistant port wine stains with the V Beam pulsed dye laser.
        Lasers Surg Med. 2003; 33: 282-287
        • Nelson J.S.
        • Kelly K.M.
        • Zhao Y.
        • et al.
        Imaging blood flow in human port-wine stain in situ and in real time using optical Doppler tomography.
        Arch Dermatol. 2001; 137: 741-744
        • Troilius A.
        • Svendsen G.
        • Ljunggren B.
        Ultrasound investigation of port wine stains.
        Acta Derm Venereol. 2000; 80: 196-199
        • Troilius A.M.
        • Ljunggren B.
        Evaluation of port wine stains by laser Doppler perfusion imaging and reflectance photometry before and after pulsed dye laser treatment.
        Acta Derm Venereol. 1996; 76: 291-294
        • Michel S.
        • Landthaler M.
        • Hohenleutner U.
        Recurrence of port-wine stains after treatment with the flashlamp-pumped pulsed dye laser.
        Br J Dermatol. 2000; 143: 1230-1234
        • Ozluer S.M.
        • Barlow R.J.
        Partial re-emergence of a port-wine stain following successful treatment with flashlamp-pumped dye laser.
        Clin Exp Dermatol. 2001; 26: 37-39
        • Viator J.A.
        • Au G.
        • Paltauf G.
        • et al.
        Clinical testing of a photoacoustic probe for port wine stain depth determination.
        Lasers Surg Med. 2002; 30: 141-148
        • Lindan O.
        • Greenway R.M.
        • Piazza J.M.
        Pressure distribution on the surface of the human body. Evaluation in lying and sitting positions using a ‘bed of springs and nails’.
        Arch Phys Med Rehabil. 1965; 46: 378-385