Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Dermatol. 2020 Apr;47(4):348-355. doi: 10.1111/1346-8138.15238. Epub 2020 Feb 3.
Pulsed dye laser-resistant port-wine stains present a therapeutic challenge. The aim of this study was to evaluate the efficacy and safety of photodynamic therapy for treating these lesions. A total of 67 patients with pulsed dye laser-resistant cervicofacial port-wine stains were retrospectively assessed after undergoing photodynamic therapy mediated with a combination of hemoporfin and 532-nm light. For objective evaluation of photodynamic therapy efficacy, first, the colorimetric changes in the port-wine stain lesions were evaluated according to the Lab* color coordinate system, then the values of color changes (ΔE) and blanching rate were calculated. For subjective evaluation of improvement, photographs taken before and after photodynamic therapy were evaluated by three independent assessors blindly. Patient satisfaction was also used as a factor in the subjective evaluation. Adverse events were recorded after treatment. The median ΔE decreased significantly from the pretreatment value of 13.42 to 9.90 at the 2-month follow up (P < 0.001). The median blanching rate of port-wine stains was 28.04% after an average of 1.21 sessions of photodynamic therapy. Based on the overall visual assessment, 46.2% patients showed excellent or good levels of improvement (>50% color blanching). Adverse events were minimal, transient and self-limiting. In conclusion, photodynamic therapy serves as an alternative means to treat pulsed dye laser-resistant port-wine stains.
脉冲染料激光难治性葡萄酒色斑治疗具有挑战性。本研究旨在评估光动力疗法治疗这些病变的疗效和安全性。回顾性分析了 67 例经血卟啉与 532nm 激光联合介导的光动力疗法治疗的难治性颈面部葡萄酒色斑患者。为了客观评估光动力疗法的疗效，首先根据 Lab*颜色坐标系统评估葡萄酒色斑病变的颜色变化，然后计算颜色变化的数值（ΔE）和变白率。为了对改善进行主观评估，对光动力治疗前后的照片由 3 名独立评估员进行盲法评估。患者满意度也作为主观评估的一个因素。治疗后记录不良反应。与治疗前相比，2 个月随访时中位ΔE 从 13.42 显著降低至 9.90（P<0.001）。经平均 1.21 次光动力治疗后，葡萄酒色斑的中位变白率为 28.04%。根据整体视觉评估，46.2%的患者显示出优异或良好的改善水平（>50%的颜色变白）。不良反应轻微、短暂且自限性。总之，光动力疗法是治疗脉冲染料激光难治性葡萄酒色斑的一种替代方法。
