Retrospective study of photodynamic therapy for pulsed dye laser-resistant port-wine stains.
Adolescent
Adult
Child
Child, Preschool
Disease Resistance
Face
Female
Hematoporphyrins
/ administration & dosage
Humans
Lasers, Dye
/ therapeutic use
Low-Level Light Therapy
/ methods
Male
Middle Aged
Neck
Patient Satisfaction
Photochemotherapy
/ methods
Port-Wine Stain
/ therapy
Retrospective Studies
Treatment Outcome
Young Adult
photodynamic therapy
port-wine stain
pulsed dye laser
pulsed dye laser resistance
treatment efficacy
Journal
The Journal of dermatology
ISSN: 1346-8138
Titre abrégé: J Dermatol
Pays: England
ID NLM: 7600545
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
28
08
2019
accepted:
24
12
2019
pubmed:
6
2
2020
medline:
7
1
2021
entrez:
4
2
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 32012364
doi: 10.1111/1346-8138.15238
doi:
Substances chimiques
Hematoporphyrins
0
hematoporphyrin monomethyl ether
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
348-355Informations de copyright
© 2020 Japanese Dermatological Association.
Références
Wassef M, Blei F, Adams D, et al. Vascular anomalies classification: recommendations from the international society for the study of vascular anomalies. Pediatrics 2015; 136: e203-e214.
Jacobs AH, Walton RG. The incidence of birthmarks in the neonate. Pediatrics 1976; 58: 218-222.
Barsky SH, Rosen S, Geer DE, Noe JM. The nature and evolution of port wine stains: a computer-assisted study. J Invest Dermatol 1980; 74: 154-157.
Renfro L, Geronemus RG. Anatomical differences of port-wine stains in response to treatment with the pulsed dye laser. Arch Dermatol 1993; 129: 182-188.
Lanigan SW, Cotterill JA. Psychological disabilities amongst patients with port wine stains. Br J Dermatol 1989; 121: 209-215.
Jasim ZF, Handley JM. Treatment of pulsed dye laser-resistant port wine stain birthmarks. J Am Acad Dermatol 2007; 57: 677-682.
Yung A, Sheehan-Dare R. A comparative study of a 595-nm with a 585-nm pulsed dye laser in refractory port wine stains. Br J Dermatol 2005; 153: 601-606.
Huikeshoven M, Koster PH, de Borgie CA, Beek JF, van Gemert MJ, van der Horst CM. Redarkening of port-wine stains 10 years after pulsed-dye-laser treatment. N Engl J Med 2007; 356: 1235-1240.
Lanigan SW, Taibjee SM. Recent advances in laser treatment of port-wine stains. Br J Dermatol 2004; 151: 527-533.
Lanigan SW. Port-wine stains unresponsive to pulsed dye laser: explanations and solutions. Br J Dermatol 1998; 139: 173-177.
Yang MU, Yaroslavsky AN, Farinelli WA, et al. Long-pulsed neodymium:yttrium-aluminum-garnet laser treatment for port-wine stains. J Am Acad Dermatol 2005; 52: 480-490.
Chen JK, Ghasri P, Aguilar G, et al. An overview of clinical and experimental treatment modalities for port wine stains. J Am Acad Dermatol 2012; 67: 289-304.
Chowdhury MM, Harris S, Lanigan SW. Potassium titanyl phosphate laser treatment of resistant port-wine stains. Br J Dermatol 2001; 144: 814-817.
Woo WK, Jasim ZF, Handley JM. Evaluating the efficacy of treatment of resistant port-wine stains with variable-pulse 595-nm pulsed dye and 532-nm Nd:YAG lasers. Dermatol Surg 2004; 30: 158-162.
Borges da Costa J, Boixeda P, Moreno C, Santiago J. Treatment of resistant port-wine stains with a pulsed dual wavelength 595 and 1064 nm laser: a histochemical evaluation of the vessel wall destruction and selectivity. Photomed Laser Surg 2009; 27: 599-605.
Grillo E, González-Muñoz P, Boixeda P, Cuevas A, Vañó S, Jaén P. Alexandrite laser for the treatment of resistant and hypertrophic port wine stains: a clinical, histological and histochemical study. Actas Dermosifiliogr 2016; 107: 591-596.
Bjerring P, Christiansen K, Troilius A. Intense pulsed light source for the treatment of dye laser resistant port-wine stains. J Cosmet Laser Ther 2003; 5: 7-13.
Savas JA, Ledon JA, Franca K, Chacon A, Nouri K. Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment. Br J Dermatol 2013; 168: 941-953.
Orenstein A, Nelson JS, Liaw LH, Kaplan R, Kimel S, Berns MW. Photochemotherapy of hypervascular dermal lesions: a possible alternative to photothermal therapy? Lasers Surg Med 1990; 10: 334-343.
Lin XX, Wang W, Wu SF, Yang C, Chang TS. Treatment of capillary vascular malformation (port-wine stains) with photochemotherapy. Plast Reconstr Surg 1997; 99: 1826-1830.
Xiao Q, Li Q, Yuan KH, Cheng B. Photodynamic therapy of port-wine stains: long-term efficacy and complication in Chinese patients. J Dermatol 2011; 38: 1146-1152.
Zhao Y, Tu P, Zhou G, et al. Hemoporfin photodynamic therapy for port-wine stain: a randomized controlled trial. Plos One 2016; 11: e0156219.
Tang Y, Xie H, Li J, Jian D. The association between treatment reactions and treatment efficiency of Hemoporfin-photodynamic therapy on port wine stains: A prospective double blind randomized controlled trial. Photodiagnosis Photodyn Ther 2017; 18: 171-178.
Li-Qiang G, Hua W, Si-Li N, Chun-Hu T. A clinical study of HMME-PDT therapy in Chinese pediatric patients with port-wine stain. Photodiagnosis Photodyn Ther 2018; 23: 102-105.
Zhang Y, Yang Y, Zhang Z, et al. Clinical study on hemoporfin PDT for infant facial port-wine stains. Photodiagnosis Photodyn Ther 2019; 25: 106-110.
Gu Y, Huang NY, Liang J, Pan YM, Liu FG. Clinical study of 1949 cases of port wine stains treated with vascular photodynamic therapy (Gu's PDT). Ann Dermatol Venereol 2007; 134: 241-244.
Kelly KM, Kimel S, Smith T, et al. Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels. Lasers Surg Med 2004; 34: 407-413.
Mei Y, Xiao X, Fan L, et al. In vitro photodynamic therapy of endothelial cells using hematoporphyrin monomethyl ether (Hemoporfin): Relevance to treatment of port wine stains. Photodiagnosis Photodyn Ther 2019; 27: 268-275.
Moy WJ, Yao J, de Feraudy SM, et al. Histologic changes associated with talaporfin sodium-mediated photodynamic therapy in rat skin. Lasers Surg Med 2017; 49: 767-772.
Yuan KH, Li Q, Yu WL, Zeng D, Zhang C, Huang Z. Comparison of photodynamic therapy and pulsed dye laser in patients with port wine stain birthmarks: a retrospective analysis. Photodiagnosis Photodyn Ther 2008; 5: 50-57.
Gao K, Huang Z, Yuan KH, Zhang B, Hu ZQ. Side-by-side comparison of photodynamic therapy and pulsed-dye laser treatment of port-wine stain birthmarks. Br J Dermatol 2013; 168: 1040-1046.
Zhang B, Zhang TH, Huang Z, Li Q, Yuan KH, Hu ZQ. Comparison of pulsed dye laser (PDL) and photodynamic therapy (PDT) for treatment of facial port-wine stain (PWS) birthmarks in pediatric patients. Photodiagnosis Photodyn Ther 2014; 11: 491-497.
Yu W, Ying H, Chen Y, et al. In vivo investigation of the safety and efficacy of pulsed dye laser with two spot sizes in port-wine stain treatment: a prospective side-by-side comparison. Photomed Laser Surg 2017; 35: 465-471.
Yu W, Zhu J, Wang L, et al. Double pass 595 nm pulsed dye laser does not enhance the efficacy of port wine stains compared with single pass: a randomized comparison with histological examination. Photomed Laser Surg 2018; 36: 305-312.
Yu W, Zhu J, Changc SJ, et al. Shorter treatment intervals of east asians with port-wine stain with pulsed dye laser are safe and effective-a prospective side-by-side comparison. Photomed Laser Surg 2018; 36: 37-43.
Baquie M, Kasraee B. Discrimination between cutaneous pigmentation and erythema: comparison of the skin colorimeters Dermacatch and Mexameter. Skin Res Technol 2014; 20: 218-227.
van der Horst CMAM, Koster PHL, de Borgie CAJM, Bossuyt PMM, van Gemert MJC. Effect of the timing of treatment of port-wine stains with the flash-lamp-pumped pulsed-dye laser. N Engl J Med 1998; 338: 1028-1033.
Rah DK, Kim SC, Lee KH, Park BY, Kim DW. Objective evaluation of treatment effects on port-wine stains using L*a*b* color coordinates. Plast Reconstr Surg 2001; 108: 842-847.
Nguyen CM, Yohn JJ, Huff C, Weston WL, Morelli JG. Facial port wine stains in childhood: prediction of the rate of improvement as a function of the age of the patient, size and location of the port wine stain and the number of treatments with the pulsed dye (585 nm) laser. Br J Dermatol 1998; 138: 821-825.
Yu W, Ma G, Qiu Y, et al. Why do port-wine stains (PWS) on the lateral face respond better to pulsed dye laser (PDL) than those located on the central face? J Am Acad Dermatol 2016; 74: 527-535.
Ohtsuka H. Port wine stain: distribution patterns on the face and neck. Ann Plast Surg 1990; 24: 409-413.
McGill DJ, MacLaren W, Mackay IR. A direct comparison of pulsed dye, alexandrite, KTP and Nd:YAG lasers and IPL in patients with previously treated capillary malformations. Lasers Surg Med 2008; 40: 390-398.
Rizzo C, Brightman L, Chapas AM, et al. Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis. Dermatol Surg 2009; 35: 1947-1954.
Zhao Y, Zhou Z, Zhou G, et al. Efficacy and safety of hemoporfin in photodynamic therapy for port-wine stain: a multicenter and open-labeled phase IIa study. Photodermatol Photoimmunol Photomed 2011; 27: 17-23.
Wu Q, Tu P, Zhou G, et al. A dose-finding study for hemoporfin in photodynamic therapy for port-wine stain: A multicenter randomized double-blind phase IIb trial. Photodermatol Photoimmunol Photomed 2018; 34: 314-321.
Yuan KH, Li Q, Yu WL, Huang Z. Photodynamic therapy in treatment of port wine stain birthmarks-recent progress. Photodiagnosis Photodyn Ther 2009; 6: 189-194.
Lu YG, Wu JJ, Yang YD, Yang HZ, He Y. Photodynamic therapy of port-wine stains. J Dermatolog Treat 2010; 21: 240-244.
Yu W, Ma G, Qiu Y, et al. 18 years long-term results of facial port-wine stain (PWS) after photodynamic therapy (PDT)-a case report. Photodiagnosis Photodyn Ther 2015; 12: 143-145.
Pu Y, Chen W, Yu Z. Research progress of Hemoporfin-part one: preclinical study. Photodiagnosis Photodyn Ther 2012; 9: 180-185.
Qiu H, Zhou Y, Gu Y, et al. Monitoring microcirculation changes in port wine stains during vascular targeted photodynamic therapy by laser speckle imaging. Photochem Photobiol 2012; 88: 978-984.
Yuan KH, Gao JH, Huang Z. Adverse effects associated with photodynamic therapy (PDT) of port-wine stain (PWS) birthmarks. Photodiagnosis Photodyn Ther 2012; 9: 332-336.
Fiskerstrand EJ, Svaasand LO, Kopstad G, Ryggen K, Aase S. Photothermally induced vessel-wall necrosis after pulsed dye laser treatment: lack of response in port-wine stains with small sized or deeply located vessels. J Invest Dermatol 1996; 107: 671-675.
Katugampola GA, Lanigan SW. Laser treatment of port-wine stains: therapeutic outcome in relation to morphological parameters. Br J Dermatol 1997; 136: 467-468.