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White gel pen easily marks a port-wine stain margin during pulsed dye laser therapy.

During PDL irradiation, delineating the margins of the PWS is useful in treating the entirety of the lesion appropriately. When the practitioner wears laser safety glasses during treatment, the exact margin of the lesion can be difficult to visualize. In addition, as the laser treatment proceeds, there is often reactive vasodilation, which can obscure the lesional borders. Lastly, many pen inks pose a laser safety risk because the pigment may also absorb the laser energy. There have been reports of lasers causing flash fires with resultant burning of the skin in areas where the laser beam contacted pigmented ink. Initially, we used a yellow highlighter marker to delineate lesional borders, but it was difficult to remove. We describe a technique using a white gel pen to safely mark the border of PWSs for PDL treatment. Technique