Skip to main content

Superficial hemangioma is better treated by topical 5-aminolevulinic followed by 595-nm pulsed dye laser therapy rather than 595-nm laser therapy alone

Lasers in Medical Science volume 32, pages 1889–1893 (2017)Cite this article

Abstract

The aim of this study was to compare the efficacy and adverse effects of a 595-nm pulsed dye laser therapy alone (PDL alone) with a 5-aminolevulinic (5-ALA) local application followed by a 595-nm PDL (5-ALA PDL) in the treatment of superficial hemangioma (SH). A prospectively randomized study in 181 patients with SH was carried out over a period of 24 months. One hundred and ninety-three patients were seen. One hundred and eighty-one patients with SH were enrolled, of which 165 completed final follow-up. One hundred and nineteen patients received PDL alone and 46 received 5-ALA PDL. The patients were assessed clinically and the patient’s parents were given a satisfaction questionnaire. Baseline patient data (gender, lesion size, lesion site, treatment times, cure rate, and adverse reactions) were recorded and the results of the treatment of the two groups were analyzed and compared. Complete clearing of the lesion (recovery grade 4) was achieved in 44/119 (37.0%) of the PDL alone group and 31/46 (67.4%) of the 5-ALA PDL group (X 2 = 10.30, p < 0.001). Atrophic scars, hyper- and hypopigmentation occurred in both groups (X 2 = 3.32, p = 0.564). The patients’ parents’ satisfaction was greater in the 5-ALA PDL group. The clinical outcome of 5-ALA PDL was superior to that of PDL alone in the treatment of SH and only minor adverse events occurred in each group.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Sidbury R (2010) Update on vascular tumors of infancy. Curr Opin Pediatr 22(4):432–437

    Article  PubMed  Google Scholar 

  2. Williams EF 3rd, Hochman M, Rodgers BJ, Brockbank D, Shannon L, Lam SM (2003) A psychological profile of children with hemangiomas and their families. Arch Facial Plast Surg 5(3):229–234

    Article  PubMed  Google Scholar 

  3. Liu A, Moy RL, Ross EV, Hamzavi I, Ozog DM (2012) Pulsed dye laser and pulsed dye laser-mediated photodynamic therapy in the treatment of dermatologic disorders. Dermatol Surg 38(3):351–366

    CAS  Article  PubMed  Google Scholar 

  4. Babilas P, Shafirstein G, Bäumler W, Baier J, Landthaler M, Szeimies RM, Abels C (2005) Selective photothermolysis of blood vessels following flashlamp-pumped pulsed dye laser irradiation: in vivo results and mathematical modelling are in agreement. J Invest Dermatol 125(2):343–352

    CAS  Article  PubMed  Google Scholar 

  5. Weiss A, den Bergh HV, Griffioen AW, Nowak-Sliwinska P (2012) Angiogenesis inhibition for the improvement of photodynamic therapy: the revival of a promising idea. Biochim Biophys Acta 1826(1):53–70

    CAS  PubMed  Google Scholar 

  6. Allison RR, Sibata CH (2010) Photodynamic therapy: mechanism of action and role in the treatment of skin disease. G Ital Dermatol Venereol 145(4):491–507

    CAS  PubMed  Google Scholar 

  7. Xiao Q, Li Q, Yuan KH, Cheng B (2011) Photodynamic therapy of port-wine stains: long-term efficacy and complication in Chinese patients. J Dermatol 38(12):1146–1152

    CAS  Article  PubMed  Google Scholar 

  8. Li W, Yamada I, Masumoto K, Ueda Y, Hashimoto K (2010) Photodynamic therapy with intradermal administration of 5-aminolevulinic acid for port-wine stains. J Dermatolog Treat 21(4):232–239

    CAS  Article  PubMed  Google Scholar 

  9. Liu S, Yang C, Yang S, Wang Z, Luo D, Zhang X (2012) Topical application of 5-aminolevulinic acid followed by 595-nm pulsed dye laser irradiation for the treatment of recalcitrant port-wine stains: a primary study. J Cosmet Laser Ther 14(4):189–192

    Article  PubMed  Google Scholar 

  10. Hunzeker CM, Geronemus RG (2010) Treatment of superficial infantile hemangiomas of the eyelid using the 595-nm pulsed dye laser. Dermatol Surg 36(5):590–597

    CAS  Article  PubMed  Google Scholar 

  11. Rizzo C, Brightman L, Chapas AM, Hale EK, Cantatore-Francis JL, Bernstein LJ, Geronemus RG (2009) Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis. Dermatol Surg 35(12):1947–1954

    CAS  Article  PubMed  Google Scholar 

  12. Tay YK, Tan SK (2012) Treatment of infantile hemangiomas with the 595-nm pulsed dye laser using different pulse widths in an Asian population. Laser Surg med 44(2):93–96

    Article  Google Scholar 

  13. Chen W, Liu S, Yang C, Yang S (2015) Clinical efficacy of the 595 nm pulsed dye laser in the treatment of childhood superficial hemangioma - analysis of 10-year application in Chinese patients. J Dermatolog Treat 26(1):54–58

    CAS  Article  PubMed  Google Scholar 

  14. Chen W, Yang C, Liu S, Yang S (2014) Curative effect study of pulsed dye laser in the treatment of 43 patients with hand infantile hemangioma. Eur J Dermatol 24(1):76–79

    CAS  PubMed  Google Scholar 

  15. Mulliken JB, Glowacki J (1982) Classification of pediatric vascular lesions. Plast Reconstr Surg 70(1):120–121

    CAS  Article  PubMed  Google Scholar 

  16. Sandell JL, Zhu TC (2011) A review of in-vivo optical properties of human tissues and its impact on PDT. J Biophotonics 4(11–12):773–787

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sakamoto FH, Doukas AG, Farinelli WA, Tannous Z, Su Y, Smith NA, Zurakowski D, Anderson RR (2011) Intracutaneous ALA hotodynamic herapy: dose-dependent targeting of skin structures. Lasers Surg Med 43(7):621–631

    Article  PubMed  Google Scholar 

  18. Henderson BW, Fingar VH (1987) Relationship of tumor hypoxia and response to photodynamic treatment in an experimental mouse tumor. Cancer Res 47(12):3110–3114

    CAS  PubMed  Google Scholar 

  19. Moan J, Ma LW, Iani V (2001) On the pharmacokinetics of topically applied 5-aminolevulinic acid and two of its esters. Int J Cancer 92(1):139–143

    CAS  Article  PubMed  Google Scholar 

  20. de Bruijn HS, Meijers C, van der Ploeg-van den Heuvel A, Sterenborg HJ, Robinson DJ (2008) Microscopic localisation of protoporphyrin IX in normal mouse skin after topical application of 5-aminolevulinic acid or methyl 5-aminolevulinate. J Photochem Photobiol B 92(2):91–97

    Article  PubMed  Google Scholar 

  21. de Bruijn HS, Kruijt B, van der Ploeg-van den Heuvel A, Sterenborg HJ, Robinson DJ (2007) Increase in protoporphyrin IX after 5-aminolevulinic acid based photodynamic therapy is due to local re-synthesis. Photochem Photobiol Sci 6(8):857–864

    Article  PubMed  Google Scholar 

  22. Ang M, Lee SY (2012) Multifocal photodynamic therapy for diffuse choroidal hemangioma. Clin Ophthalmol 6:1467–1469

    Article  PubMed  PubMed Central  Google Scholar 

  23. Papastefanou VP, Pilli S, Stinghe A, Lotery AJ, Cohen VM (2013) Photodynamic therapy for retinal capillary hemangioma. Eye (Lond) 27(3):438–442

    CAS  Article  Google Scholar 

  24. Jerjes W, Upile T, Hamdoon Z, Mosse CA (2011) Interstitial PDT for vascular anomalies. Lasers Surg Med 43(5):357–365

    Article  PubMed  Google Scholar 

Download references

Funding

The sources are the Anhui Province Natural Science Foundation Project (No 1608085MH194) and the fund for youth of The First Affiliated Hospital of Anhui Medical University (2013KJ17, 2013KJ18).

Author information

Affiliations

  1. Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

    Ming Zeng, Songke Shen & ShengXiu Liu

  2. Charles Institute of Dermatology, University College Dublin, Dublin, Dublin, 4, Ireland

    Ming Zeng

  3. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

    Wei Chen

  4. Department of Dermatology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China

    Chunjun Yang

Authors
  1. Ming Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Songke Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chunjun Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. ShengXiu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to ShengXiu Liu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

First authors of Ming Zeng and Songke Shen contribute equally.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zeng, M., Shen, S., Chen, W. et al. Superficial hemangioma is better treated by topical 5-aminolevulinic followed by 595-nm pulsed dye laser therapy rather than 595-nm laser therapy alone. Lasers Med Sci 32, 1889–1893 (2017). https://doi.org/10.1007/s10103-017-2304-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-017-2304-9

Keywords

  • Superficial hemangioma
  • Photodynamic therapy
  • Pulsed dye laser