You Ruixuan, Tan Yixin, Zhang Xueqin, Li Lu, Zeng Ting, Zhou Yixin, Shi Yaqian, Shao Yongqi, Yan Hongxia, Xiao Rong, Qiu Xiangning
Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China.
Clinical Medical Research Center of Major Skin Diseases and Skin Health of Hunan Province, The Second Xiangya Hospital of Central South University, Changsha, China.
J Cosmet Dermatol. 2025 Apr;24(4):e70153. doi: 10.1111/jocd.70153.
Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a novel and promising treatment for port-wine stains (PWS); however, the factors affecting the efficacy and safety are controversial.
In this study, the relationship between influential factors and the efficacy and safety of HMME-PDT for facial PWS was clarified.
In this retrospective study, 155 patients suffering from facial PWS who underwent HMME-PDT at 2-3 months interval were included. The efficacy was evaluated by the facial PWS area and severity index (FSASI) scoring system based on pre- and post-treatment photographs of the lesion. The demographic characteristics, lesion patterns, treatment history, number of treatment sessions, and adverse events were also recorded.
After the first and second sessions of HMME-PDT, 61.9% and 92.9% of patients responded, respectively. The lesion subtype, degree of lip involvement, and number of HMME-PDT sessions were associated with the efficacy of HMME-PDT (p = 0.014, p = 0.034, p < 0.001, and respectively). Logistic regression analysis confirmed that the patients with red-type PWS (p = 0.019) and more HMME-PDT sessions (≥ 2) (p < 0.001) showed an association with a better response to HMME-PDT. The response rate was higher for lesions on the mandibular prominence area than that on the forehead area (p = 0.031). No photosensitivity or systemic adverse reactions were reported. Most adverse effects were well tolerated in all patients. Furthermore, the severity of crust was found positively associated with the efficacy (p < 0.001).
HMME-PDT is an effective and safe treatment approach for treating facial PWS. Patients who had red-type, nonforehead area, and more treatment sessions showed an association with better efficacy.
血卟啉介导的光动力疗法（HMME-PDT）是一种治疗鲜红斑痣（PWS）的新型且有前景的疗法；然而，影响其疗效和安全性的因素存在争议。
本研究阐明了影响因素与HMME-PDT治疗面部PWS的疗效和安全性之间的关系。
在这项回顾性研究中，纳入了155例面部PWS患者，他们每隔2 - 3个月接受一次HMME-PDT治疗。根据病变治疗前后的照片，采用面部PWS面积和严重程度指数（FSASI）评分系统评估疗效。还记录了人口统计学特征、病变模式、治疗史、治疗次数和不良事件。
在第一次和第二次HMME-PDT治疗后，分别有61.9%和92.9%的患者有反应。病变亚型、唇部受累程度和HMME-PDT治疗次数与HMME-PDT的疗效相关（分别为p = 0.014、p = 0.034、p < 0.001）。逻辑回归分析证实，红色型PWS患者（p = 0.019）和更多次HMME-PDT治疗（≥2次）（p < 0.001）与对HMME-PDT的更好反应相关。下颌突出区域病变的反应率高于前额区域病变（p = 0.031）。未报告光敏反应或全身不良反应。所有患者对大多数不良反应耐受性良好。此外，痂皮的严重程度与疗效呈正相关（p < 0.001）。
HMME-PDT是治疗面部PWS的一种有效且安全的治疗方法。红色型、非前额区域且治疗次数更多的患者疗效更佳。
