Hematoporphyrin monomethyl ether photodynamic therapy for the treatment of facial port-wine stains resistant to pulsed dye laser

Photodiagnosis Photodyn Ther. 2020 Sep:31:101820. doi: 10.1016/j.pdpdt.2020.101820. Epub 2020 May 16.

Abstract

Background: Pulsed dye laser is the first treatment choice for port-wine stains. However, as some facial port-wine stains are resistant to this modality, we evaluated the efficacy and safety of hematoporphyrin monomethyl ether (hemoporfin) photodynamic therapy for the treatment of such resistant port-wine stains.

Methods: Patients were treated with two sessions of hemoporfin photodynamic therapy in our department. Patients received an intravenous injection of hematoporphyrin monomethyl ether (5 mg/kg) followed by 532 nm LED green light therapy. Three physicians graded the improvement in the port-wine stain, using a 4-level scale. Patients' satisfaction, reaction to treatment, and adverse effects were evaluated.

Results: Thirty-one patients (mean age, 23.9 ± 11.9 years, range, 3-48 years) were enrolled in this study. Hypertrophic lesions accounted for 48.4% of port-wine stain, with 80.6% of lesions being larger than 40 cm2. With regard to location, 41.9% were located on the central face and 32.3% involved a mix of the central and peripheral face. After one session, a treatment response was identified in 87.1% of cases, with the response deemed 'significant' in 29.0%. After two sessions, these rates increased to 100.0% and 61.3%, respectively. The clinical effect after two sessions was significantly greater than that after one session. Treatment reactions and adverse effects were well tolerated, and included pruritus, burning sensation, pain, edema, purpura-like change, blister, crust, and hyperpigmentation.

Conclusions: Hemoporfin photodynamic therapy is a promising treatment for port-wine stains resistant to pulsed dye laser therapy.

Keywords: Hematoporphyrin monomethyl; Hemoporfin; Photodynamic therapy; Port wine stain; Pulsed dye laser; Resistant.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Hematoporphyrins
  • Humans
  • Laser Therapy*
  • Lasers, Dye* / therapeutic use
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Port-Wine Stain* / drug therapy
  • Treatment Outcome
  • Young Adult

Substances

  • Hematoporphyrins
  • Photosensitizing Agents
  • hematoporphyrin monomethyl ether