Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China.
J Dermatol. 2021 Nov;48(11):1700-1708. doi: 10.1111/1346-8138.16094. Epub 2021 Aug 6.
Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a vascular-targeted treatment for port-wine stains (PWS). However, the efficacy of this has varied and is difficult to predict. The objective of this study was to evaluate the efficacy of influential factors associated with HMME-PDT and provide a suitable method for predicting the efficacy. Patients with facial PWS who underwent HMME-PDT were retrospective analyzed. A total of 212 patients (93 males) with mean age of 13.01 ± 12.67 years (range, 1-51) years were included. There were 143 cases with red, 56 cases with purple, and 13 cases with hypertrophic-type PWS. The number of HMME-PDT sessions ranged 1-6. The excellent response rate after 1-4 PDT sessions was 9.4%, 17.6%, 32.7%, and 42.9%, respectively. The number of PDT treatments is associated with efficacy, and patients who underwent treatment with more than three sessions had response better than those who underwent treatment with less than three sessions (p = 0.003). Response to HMME-PDT in patients of different ages, previous treatment history, lip involvement, and vessels morphology showed significant differences after two treatment sessions (p = 0.001, 0.03, 0.014, and 0.001, respectively), while patients of different sex, subtype, lesion size, location (medial, lateral, or mixed), or non-vascular morphology showed no significant differences. Logistic regression analysis confirmed that the patients with lip hypertrophy (p = 0.002), history of more than five times prior treatment (p = 0.003), fewer PDT sessions (<3) (p = 0.000002), linear vessels (p = 0.007), and reticular vessels (p = 0.0003) showed association with poor response of HMME-PDT. In conclusion, HMME-PDT is an effective treatment for PWS. Patients who had underwent treatment for more than five times prior, lip hypertrophy, and linear vessels or reticular vessels under dermoscope showed association with poor efficacy.
血卟啉单甲醚介导的光动力疗法（HMME-PDT）是一种针对葡萄酒色斑（PWS）的血管靶向治疗方法。然而，其疗效存在差异，且难以预测。本研究旨在评估与 HMME-PDT 相关的影响因素的疗效，并提供一种合适的方法来预测疗效。对接受 HMME-PDT 的面部 PWS 患者进行回顾性分析。共纳入 212 例（男 93 例）患者，平均年龄为 13.01±12.67 岁（范围 1-51 岁）。其中红色 143 例，紫色 56 例，肥厚型 13 例。HMME-PDT 治疗次数范围为 1-6 次。1-4 次 PDT 后，优秀反应率分别为 9.4%、17.6%、32.7%和 42.9%。治疗次数与疗效相关，治疗次数大于 3 次的患者疗效优于治疗次数小于 3 次的患者（p=0.003）。经过两次治疗后，不同年龄、既往治疗史、唇部受累和血管形态的患者对 HMME-PDT 的反应存在显著差异（p=0.001、0.03、0.014 和 0.001），而不同性别、亚型、病变大小、位置（内侧、外侧或混合）或非血管形态的患者则无显著差异。Logistic 回归分析证实，唇部肥大（p=0.002）、既往治疗次数大于 5 次（p=0.003）、治疗次数小于 3 次（p=0.000002）、线性血管（p=0.007）和网状血管（p=0.0003）与 HMME-PDT 疗效差相关。总之，HMME-PDT 是一种治疗 PWS 的有效方法。既往治疗次数大于 5 次、唇部肥大、在皮肤镜下显示线性血管或网状血管的患者与疗效差相关。
