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光动力疗法(PDT)治疗葡萄酒色斑(PWS)胎记的不良反应。

Adverse effects associated with photodynamic therapy (PDT) of port-wine stain (PWS) birthmarks.

机构信息

Department of Plastic and Reconstructive Surgery, Nanfang Hospital of South China Medical University, Guangzhou, China.

出版信息

Photodiagnosis Photodyn Ther. 2012 Dec;9(4):332-6. doi: 10.1016/j.pdpdt.2012.03.007. Epub 2012 Apr 17.

Abstract

BACKGROUND

Several Chinese studies suggest that Hemoporfin-mediated photodynamic therapy (PDT) is an alternative treatment for port-wine stain (PWS) birthmarks.

OBJECTIVE

To evaluate treatment responses and adverse effects associated with Hemoporfin PDT for the treatment of PWS and their management.

METHOD

The medical records of 700 patients who underwent PDT treatment in our center were retrospectively examined. Treatment-related reactions and adverse effects were reviewed.

RESULT

Different types of PWS lesions and different individuals showed different immediate responses (e.g. swelling, color change, pain). To certain extents these reactions were a useful indicator of the treatment endpoint. Edema and scabbing were the most common post-treatment responses. Short-term (e.g. blister, eczematous dermatitis, cutaneous photosensitivity) and long-term (e.g. pigmentation change, scar formation) adverse effects were generally caused by the phototoxicity associated with the combination of photosensitizer and light exposure.

CONCLUSION

Although PDT is a safe treatment alternative for PWS birthmarks, treatment parameters must be selected for each individual patient and cutaneous changes must be monitored during light irradiation to minimize the risk of adverse effects. Over estimation of required light dosage or failure to recognize cutaneous changes associated with adverse effects can increase the risk of a poor outcome.

摘要

背景

几项中国研究表明血卟啉介导的光动力疗法(PDT)是一种治疗葡萄酒色斑(PWS)胎记的替代疗法。

目的

评估血卟啉 PDT 治疗 PWS 及其管理相关的治疗反应和不良反应。

方法

回顾性检查了在我院接受 PDT 治疗的 700 例患者的病历。回顾了与治疗相关的反应和不良反应。

结果

不同类型的 PWS 病变和不同个体表现出不同的即刻反应(如肿胀、颜色变化、疼痛)。在某种程度上,这些反应是治疗终点的有用指标。水肿和结痂是最常见的治疗后反应。短期(如水疱、湿疹性皮炎、皮肤光敏性)和长期(如色素沉着改变、瘢痕形成)不良反应通常是由光毒性引起的,这种光毒性与光敏剂和光暴露的结合有关。

结论

尽管 PDT 是治疗 PWS 胎记的一种安全替代疗法,但必须为每个患者选择治疗参数,并在光照期间监测皮肤变化,以最大程度地降低不良反应的风险。高估所需的光剂量或未能识别与不良反应相关的皮肤变化会增加不良结果的风险。

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