Clinical efficacy of hematoporphyrin monomethyl ether-based photodynamic therapy for the treatment of port-wine stain and its sonographic changes

Minmin Sheng; Fang Wang; Ruzhi Zhang; Chong Wang; Li Xiao; Yuhua Yang; Yan LI; Chunxing XU; Xiaoming Liu

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Clinical efficacy of hematoporphyrin monomethyl ether-based photodynamic therapy for the treatment of port-wine stain and its sonographic changes

VernacularTitle: 海姆泊芬光动力治疗鲜红斑痣的临床疗效及声像学变化研究
Author: Minmin SHENG ¹ ; Fang WANG ¹ ; Ruzhi ZHANG ¹ ; Chong WANG ² ; Li XIAO ¹ ; Yuhua YANG ¹ ; Yan LI ¹ ; Chunxing XU ¹ ; Xiaoming LIU ¹
Author Information

1. Department of Dermatology, The Third Affiliated Hospital of Soochow University, The First People′s Hospital of Changzhou, Changzhou 213000, Jiangsu, China
2. Department of Ultrasonography, The Third Affiliated Hospital of Soochow University, The First People′s Hospital of Changzhou, Changzhou 213000, Jiangsu, China
Publication Type:Journal Article
Keywords: Port-wine stain; Hematoporphyrin photoradiation; Ultrasonography
From: Chinese Journal of Dermatology 2019;52(12):923-927
CountryChina
Language:Chinese
Abstract: Objective:To evaluate the clinical efficacy of hematoporphyrin monomethyl ether-based photodynamic (HMME-PDT) therapy for the treatment of port-wine stain (PWS) and its sonographic changes.
Methods:A total of 45 patients with confirmed PWS were enrolled from the Department of Dermatology, Third Affiliated Hospital of Soochow University from March 2017 to June 2018, including 5 with pink PWS, 39 with purplish red PWS and 1 with thickened PWS. All the patients received 3 sessions of HMME-PDT therapy. The skin thickness and density were compared before and after the treatment by using high-frequency ultrasound. Ranked data were analyzed by using nonparametric test. Measurement data were expressed as mean ± standard deviation, and analyzed using ony-way analysis of variance. Multiple comparisons were performed using Student-Newman-Keuls-q (SNK-q) test. The results were considered to be statistically significant if P < 0.05.
Results:Among the 45 patients with PWS who completed the treatment and follow-up, 10 were cured, 21 received marked improvement, 12 received improvement, and 1 showed no response. The total response rate was 97.78%, and the response rate in the patients with pink PWS was higher than that in the patients with purplish red PWS (U = 12.50, P < 0.001) . The difference value of the skin thickness or skin density before and after the treatment significantly differed among the cured patients, patients receiving marked improvement and those receiving improvement (skin thickness:0.65 ± 0.21, 0.56 ± 0.88, 0.37 ± 0.12 mm respectively; skin density: -8.65 ± 2.19, -6.86 ± 2.79, -4.92 ± 2.91 g/cm³ respectively; F = 14.528, 5.428 respectively, both P < 0.001) , and the difference values of the skin thickness and density were significantly higher in the cured patients than in those receiving improvement (q = 5.82, 4.63, both P < 0.05) . Erythematous swelling to different extents occurred at the laser-exposed sites in the zygomatic and cheek region in 23 patients with PWS and in the frontal-zygomatic region in 6 with PWS after the HMME-PDT therapy, but gradually regressed about 1 week later. Pale brown crusts were observed at the laser-exposed sites in 35 patients, and shed spontaneously about 3 weeks later. Post-inflammatory hyperpigmentation at the laser-exposed sites was observed in 4 patients, and gradually regressed after 2-month follow-up.
Conclusions:HMME-PDT therapy is effective for the treatment of PWS, with high safety and few adverse reactions. High-frequency ultrasound can be used for objectively evaluating the clinical efficacy of HMME-PDT therapy.