Tang Yan, Xie Hongfu, Li Ji, Jian Dan
Department of Dermatology, Xiangya Hospital, Central South University, China.
Photodiagnosis Photodyn Ther. 2017 Jun;18:171-178. doi: 10.1016/j.pdpdt.2017.02.005. Epub 2017 Feb 13.
Research has focused on treatment efficiency and/or treatment reactions of photodynamic therapy (PDT) on port-wine stain (PWS). But few studies reported the association between them. Hence, here we investigated the association between the treatment efficiency and treatment reactions after Hemoporfin (HMME) mediated photodynamic therapy (PDT) on PWS through a prospective study.
Patients (n=50) with PWS were randomly assigned to the HMME group or the placebo group. Three quit after the first treatment, and forty-seven received two sessions of treatment at an 8-week interval. They were given the treatment at day 1 and evaluations were performed at day 1, day 4 and week 8 in each session. HMME group was treated with HMME while the placebo group was given normal saline instead in the first session, double-blindly. While in the second session, both groups received HMME-PDT treatment.
After a single treatment, swelling was more severe in younger patients (p<0.05) and the lesion far from centro-facial showed more severe pruritus and scab. Compared with a single treatment, burning sensation had a higher occurrence rate, while burning sensation and scab were less severe in the second treatment. Importantly, severity of scab and pain (5min after irradiation) were found possibly correlated with the treatment efficiency.
HMME-PDT on PWS induces several treatment reactions, including pruritus, burning sensation, pain, swelling, blisters and scab. Two sessions of treatments do not have any accumulation effects on treatment reactions. And there might be a positive correlation between treatment efficiency and the severity of scab or pain (at early stage of the therapy), which might help in regulating treatment modalities.
研究主要聚焦于光动力疗法(PDT)治疗鲜红斑痣(PWS)的治疗效率和/或治疗反应。但鲜有研究报道二者之间的关联。因此,我们通过一项前瞻性研究,调查了血卟啉单甲醚(HMME)介导的光动力疗法(PDT)治疗PWS后治疗效率与治疗反应之间的关联。
将50例PWS患者随机分为HMME组和安慰剂组。3例患者在首次治疗后退出,47例患者接受了间隔8周的两个疗程治疗。在每个疗程的第1天进行治疗,并在第1天、第4天和第8周进行评估。HMME组在第一个疗程中接受HMME治疗,而安慰剂组则双盲给予生理盐水。在第二个疗程中,两组均接受HMME-PDT治疗。
单次治疗后,年轻患者的肿胀更严重(p<0.05),远离面中部的病变瘙痒和结痂更严重。与单次治疗相比,烧灼感的发生率更高,而在第二次治疗中烧灼感和结痂较轻。重要的是,发现结痂和疼痛的严重程度(照射后5分钟)可能与治疗效率相关。
HMME-PDT治疗PWS会引发多种治疗反应,包括瘙痒、烧灼感、疼痛、肿胀、水疱和结痂。两个疗程的治疗对治疗反应没有任何累积效应。并且治疗效率与结痂或疼痛的严重程度(在治疗早期)之间可能存在正相关,这可能有助于调整治疗方式。