Flashes of Light: From the Lab and Dermatopathology, to the World With Marty Mihm

Abstract

Martin C. (Marty) Mihm made multiple, pivotal contributions over four decades of discovery, innovation, and development leading to the world-wide application of lasers in dermatology. This started with trying to understand how pulses of light could be tailored to affect microscopic "target" structures in skin where the light is absorbed. There were many surprises, often first observed by light or electron microscopy. A host of new capabilities ensued, including laser treatments for microvascular and vascular malformations, non-melanoma pigmented lesions, tattoo and hair removal, rehabilitation of scars, improvement of photoaged skin, and lipid-targeting lasers for reduction of fat and acne. Dr. Mihm extended himself directly to patients, especially children with vascular anomalies. He contributed to the discovery that GLUT1, a glucose transporter expressed on vascular endothelium, is a defining diagnostic for infantile hemangiomas. He established a multispecialty vascular-anomalies clinic at the Massachusetts General Hospital, and co-founded the Vietnam Vascular Anomalies Center (VVAC) in Ho Chi Minh City. In Vietnam, topical radioactive phosphorus (³²P) is applied as a misguided treatment for infantile hemangiomas, leading to radiation damage in uncounted thousands of children. By teaching the use of beta-adrenergic drug treatment, the use of ³²P has been greatly reduced. Dr. Mihm pioneered the concept of pulsed dye laser (PDL) in combination with angiogenic inhibitors to improve the clinical efficacy of port wine stain (PWS) treatment. Moreover, he made seminal contributions to our understanding of the pathogenesis and spectrum of phenotypes of PWS lesions. The legacy of Martin C. Mihm extends to the entire world.