Influential Factors in the Efficacy and Safety of Hemoporfin-Mediated Photodynamic Therapy for Facial Port-Wine Stains.

BACKGROUND

Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a novel and promising treatment for port-wine stains (PWS); however, the factors affecting the efficacy and safety are controversial.

AIM: In this study, the relationship between influential factors and the efficacy and safety of HMME-PDT for facial PWS was clarified.

METHODS

In this retrospective study, 155 patients suffering from facial PWS who underwent HMME-PDT at 2-3 months interval were included. The efficacy was evaluated by the facial PWS area and severity index (FSASI) scoring system based on pre- and post-treatment photographs of the lesion. The demographic characteristics, lesion patterns, treatment history, number of treatment sessions, and adverse events were also recorded.

RESULTS

After the first and second sessions of HMME-PDT, 61.9% and 92.9% of patients responded, respectively. The lesion subtype, degree of lip involvement, and number of HMME-PDT sessions were associated with the efficacy of HMME-PDT (p = 0.014, p = 0.034, p < 0.001, and respectively). Logistic regression analysis confirmed that the patients with red-type PWS (p = 0.019) and more HMME-PDT sessions (≥ 2) (p < 0.001) showed an association with a better response to HMME-PDT. The response rate was higher for lesions on the mandibular prominence area than that on the forehead area (p = 0.031). No photosensitivity or systemic adverse reactions were reported. Most adverse effects were well tolerated in all patients. Furthermore, the severity of crust was found positively associated with the efficacy (p < 0.001).

CONCLUSION

HMME-PDT is an effective and safe treatment approach for treating facial PWS. Patients who had red-type, nonforehead area, and more treatment sessions showed an association with better efficacy.