Retrospective study of photodynamic therapy for pulsed dye laser‐resistant port‐wine stains

Abstract

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 L*a*b* 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.

Price Decomposition of Laser Treatment for Port-Wine Stain Using the Hedonic Pricing Model

“…Port-wine stain (PWS) is a congenital capillary malformation with an incidence of 3-5 per 1000 newborns [1]. Initially, it presents as a at, irregular lesion with red to purple color and it could progress into a thicker or more nodular appearance if not given treatment [2,3].…”

Surgical correction for patients with port‐wine stains and facial asymmetry

“…However, for lesions respond poorly to PDL may require a combination of treatment methods 4,5 . The flashlamp‐pumped PDL 6 and the neodymium‐doped:yttrium‐aluminum‐garnet (Nd: YAG) 7 laser are currently the criterion standard treatments for facial or aesthetically sensitive CMs. Unfortunately, even with the advancements in laser therapies utilized today, it is still difficult to achieve complete clearance of the PWS.…”

Hemoporfin photodynamic therapy for a case of unilateral nevoid telangiectasia

“…It performed excellently in the treatment of PWS, especially in PDL-resistant PWS. [ 4 ] PDT uses the cytotoxic singlet oxygen produced by the interactions between light, photosensitizers, and oxygen to damage the deformed capillary network, cause cell death, endothelial damage, thrombosis, and vascular occlusion. [ 4 , 5 ] Compared with PDL, PDT can selectively target dilated vessels of any size and penetrate deeper.…”

“…[ 4 ] PDT uses the cytotoxic singlet oxygen produced by the interactions between light, photosensitizers, and oxygen to damage the deformed capillary network, cause cell death, endothelial damage, thrombosis, and vascular occlusion. [ 4 , 5 ] Compared with PDL, PDT can selectively target dilated vessels of any size and penetrate deeper. Besides, PDT can destroy dilated vasculature through intracapillary photochemical and photothermal reactions simultaneously, but PDL only works through photothermolysis.…”

“…Besides, PDT can destroy dilated vasculature through intracapillary photochemical and photothermal reactions simultaneously, but PDL only works through photothermolysis. [ 4 ] Moreover, the normal epidermis and dermal tissues can escape the damage from PDT since the low concentration of photosensitizer in them, but high in the endothelial cells. [ 5 ] Therefore, HMME-PDT is a safe method for PWS with a high effective rate.…”