Clinical Efficacy Analysis of Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Port-Wine Stain.

OBJECTIVE

To explore the related influencing factors of hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT) for port-wine stain(PWS) and evaluate the relationship between dermoscopic vascular patterns and treatment efficacy.

METHODS

Retrospective analysis of 182 PWS patients (November 2017 to November 2023) who received HMME-PDT. Among them, 51 patients had dermoscopy before treatment. Demographic (age, gender), clinical (lesion location, colors, size, treatments), and dermoscopic data (vascular patterns) were collected. Efficacy was assessed via pre-/post-treatment photos (classified as complete regression, good improvement, slight improvement, or no improvement), and adverse reactions were recorded. SPSS 26.0 was used for statistical analysis.

RESULTS

Among 182 PWS patients, HMME-PDT achieved an overall response rate of 77.5% (141/182), with 23.6% (43) showing complete regression, 15.9% (29) demonstrating good improvement, and 37.9% (69) experiencing slight improvement; 22.5% (41) showed no improvement. Efficacy significantly correlated with age, lesion location, color, size, and treatments (p < 0.05), but not with gender or facial partition (V1, V2, V3) (p > 0.05). Multivariate analysis identified small lesion size, facial and neck, pink and purplish red lesions as positive predictors, while fewer treatment sessions were unfavorable. Seven cases (3.85%) developed long-term adverse effects (5 scars, 2 hyperpigmentations). Dermoscopic analysis of 51 vascular patterns revealed significant efficacy differences among pattern types (p < 0.05), with type I (23.5%), type II (43.2%), and type III (29.4%) showing distinct therapeutic responses.

CONCLUSION

HMME-PDT efficacy correlates with age, lesion location, color, size, and treatments, but not gender and facial partition (V1, V2, V3). Dermoscopic vascular patterns can predict treatment response, with type I being the most effective.