Zhang Mengli, Wu Qiuju, Lin Tong, Guo Lifang, Ge Yiping, Zeng Rong, Yang Yin, Rong Huizhen, Jia Gaorong, Huang Yuqing, Fang Jing, Shi Hualing, Zhao Wenwen, Chen SanJing, Cai Pingping
Department of Cosmetic Laser Surgery, Hospital for Skin Disease and Institute of Dermatology, Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042 Jiangsu Province, China.
Department of Cosmetic Laser Surgery, Hospital for Skin Disease and Institute of Dermatology, Peking Union Medical College (PUMC) & Chinese Academy of Medical Sciences (CAMS), Jiangwangmiao Street 12, Xuanwu District, Nanjing, 210042 Jiangsu Province, China.
Photodiagnosis Photodyn Ther. 2020 Sep;31:101820. doi: 10.1016/j.pdpdt.2020.101820. Epub 2020 May 16.
Pulsed dye laser is the first treatment choice for port-wine stains. However, as some facial port-wine stains are resistant to this modality, we evaluated the efficacy and safety of hematoporphyrin monomethyl ether (hemoporfin) photodynamic therapy for the treatment of such resistant port-wine stains.
Patients were treated with two sessions of hemoporfin photodynamic therapy in our department. Patients received an intravenous injection of hematoporphyrin monomethyl ether (5 mg/kg) followed by 532 nm LED green light therapy. Three physicians graded the improvement in the port-wine stain, using a 4-level scale. Patients' satisfaction, reaction to treatment, and adverse effects were evaluated.
Thirty-one patients (mean age, 23.9 ± 11.9 years, range, 3-48 years) were enrolled in this study. Hypertrophic lesions accounted for 48.4% of port-wine stain, with 80.6% of lesions being larger than 40 cm. With regard to location, 41.9% were located on the central face and 32.3% involved a mix of the central and peripheral face. After one session, a treatment response was identified in 87.1% of cases, with the response deemed 'significant' in 29.0%. After two sessions, these rates increased to 100.0% and 61.3%, respectively. The clinical effect after two sessions was significantly greater than that after one session. Treatment reactions and adverse effects were well tolerated, and included pruritus, burning sensation, pain, edema, purpura-like change, blister, crust, and hyperpigmentation.
Hemoporfin photodynamic therapy is a promising treatment for port-wine stains resistant to pulsed dye laser therapy.
脉冲染料激光是鲜红斑痣的首选治疗方法。然而，由于一些面部鲜红斑痣对这种治疗方式有抵抗性，我们评估了血卟啉单甲醚（海姆泊芬）光动力疗法治疗此类抵抗性鲜红斑痣的疗效和安全性。
患者在我科接受了两疗程的海姆泊芬光动力治疗。患者静脉注射血卟啉单甲醚（5毫克/千克），随后接受532纳米发光二极管绿光治疗。三名医生采用四级评分量表对鲜红斑痣的改善情况进行分级。评估了患者的满意度、对治疗的反应以及不良反应。
本研究纳入了31例患者（平均年龄23.9±11.9岁，范围3 - 48岁）。肥厚性病变占鲜红斑痣的48.4%，80.6%的病变面积大于40平方厘米。就位置而言，41.9%位于面部中央，32.3%累及面部中央和周边。一个疗程后，87.1%的病例出现治疗反应，其中29.0%被认为“显著”。两个疗程后，这些比例分别增至100.0%和61.3%。两个疗程后的临床效果明显优于一个疗程后。治疗反应和不良反应耐受性良好，包括瘙痒、烧灼感、疼痛、水肿、紫癜样改变、水疱、结痂和色素沉着。
海姆泊芬光动力疗法是治疗对脉冲染料激光疗法有抵抗性的鲜红斑痣的一种有前景的治疗方法。
