Skip to main content
SpringerLink
Log in

Influential Factors in the Efficacy of Hemoporfin-Mediated Photodynamic Therapy for Port-wine Stains

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Hemoporfin-mediated photodynamic therapy (HMME-PDT) is commonly used in the treatment of port-wine stains (PWS). However, the influential factors for the efficacy of the treatment are not well defined. This study intends to observe the influential factors for the efficacy of HMME-PDT in the treatment of port-wine stains (PWS). A total of 551 patients with PWS of head and neck was enrolled in this retrospective study. Further screening the patients of facial PWS, 484 patients were chosen. Patients were treated with HMME-PDT. All patients received 1~3 sessions of treatment with 2~3-month intervals. We photographed the lesions before each session and 2~3 months after the last session. Ages, sessions, lesion subtypes, and previous treatment history were related to the response of HMME-PDT (P =0.032, P<0.001, P=0.012, P=0.003 respectively). Treatment sessions were the independent factor correlated with efficacy after 3 sessions of treatment. Patients with no treatment history targeting PWS showed higher efficacy than those were treated with laser or other photodynamic treatment (P<0.05). The efficacy was higher by increasing the sessions of treatment. The efficacy was higher for lesion on maxillary prominence area and mandibular prominence area that on frontonasal prominence area and optic vesicle area (P<0.05). HMME-PDT is an effective in the treatment of PWS. Patients received no previous treatment for PWS, total treatment sessions and lesion on maxillary prominence area and mandibular prominence area are positive factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

HMME-PDT:

Hemoporfin-mediated photodynamic therapy

PWS:

Port-wine stains

PDL:

Pulsed dye laser

PDT:

Photodynamic therapy

References

  1. Tan W, Wang J, Zhou F et al (2017) Coexistence of Eph receptor B1 and ephrin B2 in port-wine stain endothelial progenitor cells contributes to clinicopathological vasculature dilatation. Br J Dermatol 177(6):1601–1611. https://doi.org/10.1111/bjd.15716

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. (CSSVA) C S F T S O V A (2019) Guidelines for the diagnosis and treatment of hemangiomas and vascular malformations. J Tissue Eng Recon Surg 15(05):277–317. https://doi.org/10.3969/j.issn.1673-0364.2019.05.001

    Article  Google Scholar 

  3. Zhang Y, Yang Y, Zhang Z et al (2019) Clinical study on hemoporfin Pdt for infant facial port-wine stains. Photodiagn Photodyn Ther 25:106–110. https://doi.org/10.1016/j.pdpdt.2018.09.012

    Article  CAS  Google Scholar 

  4. Lee S-J, Kim HY, Kim BS et al (2012) Capillary malformation of port-wine stain: differentiation from early arteriovenous malformation by histopathological clues. Am J Dermatopathol 34(5):523–528. https://doi.org/10.1097/DAD.0b013e3181b76443

    Article  PubMed  Google Scholar 

  5. Huang Y, Yang J, Sun L et al (2021) Efficacy of influential factors in hemoporfin-mediated photodynamic therapy for facial port-wine stains. J Dermatol 48(11):1700–1708. https://doi.org/10.1111/1346-8138.16094

    Article  CAS  PubMed  Google Scholar 

  6. Ding Fan CB, Yi J, Li Xie-Lun L, Yan YZ, Hong M (2021) Clinical observation of hematoporphyrin monomethyl ether photodynamic therapy for port-wine stains. J Clin Dermatol 50(04):196–201. https://doi.org/10.16761/j.cnki.1000-4963.2021.04.002

    Article  Google Scholar 

  7. Lanigan SW, Cotterill JA (1989) Psychological disabilities amongst patients with port wine stains. Brit J Dermatol 121(2):209–215. https://doi.org/10.1111/j.1365-2133.1989.tb01800.x

    Article  CAS  Google Scholar 

  8. Nguyen V, Hochman M, Mihm MC et al (2019) The pathogenesis of port wine stain and Sturge Weber syndrome: complex interactions between genetic alterations and aberrant MAPK and PI3K activation. Int J Mol Sci 20(9). https://doi.org/10.3390/ijms20092243

  9. Troilius A, Wrangsjö B, Ljunggren B (1998) Potential psychological benefits from early treatment of port-wine stains in children. Br J Dermatol 139(1):59–65. https://doi.org/10.1046/j.1365-2133.1998.02314.x

    Article  CAS  PubMed  Google Scholar 

  10. Jasim ZF, Handley JM (2007) Treatment of pulsed dye laser–resistant port wine stain birthmarks. J Am Acad Dermatol 57(4):677–682. https://doi.org/10.1016/j.jaad.2007.01.019

    Article  PubMed  Google Scholar 

  11. Gao K, Huang Z, Yuan KH et al (2013) Side-by-side comparison of photodynamic therapy and pulsed-dye laser treatment of port-wine stain birthmarks. Brit J Dermatol 168(5):1040–1046. https://doi.org/10.1111/bjd.12130

    Article  CAS  Google Scholar 

  12. Han Y, Ying H, Zhang X et al (2020) Retrospective study of photodynamic therapy for pulsed dye laser-resistant port-wine stains. J Dermatol 47(4):348–355. https://doi.org/10.1111/1346-8138.15238

    Article  CAS  PubMed  Google Scholar 

  13. Kelly KM, Kimel S, Smith T et al (2004) Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels. Lasers Surg Med: The Official J American Society for Laser Med Surg 34(5):407–413. https://doi.org/10.1002/lsm.20041

    Article  Google Scholar 

  14. Gu Y, Liu F, Wang K et al (2001) A clinic analysis of 1216 cases of port wine stain treated by photodynamic therapy. Chinese J Laser Med (02):21–24. https://doi.org/10.13480/j.issn1003-9430.2001.02.008

    Article  Google Scholar 

  15. Li DC, Nong X, Hu ZY et al (2020) Efficacy and related factors analysis in Hmme-PDT in the treatment of port wine stains. Photodiagn Photodyn 29:101649. https://doi.org/10.1016/j.pdpdt.2020.101649

    Article  CAS  Google Scholar 

  16. Mei Y, Xiao X, Fan L et al (2019) In vitro photodynamic therapy of endothelial cells using hematoporphyrin monomethyl ether (Hemoporfin): relevance to treatment of port wine stains. Photodiagnosis Photodyn Ther 27:268–275. https://doi.org/10.1016/j.pdpdt.2019.06.003

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Wu Q, Tu P, Zhou G et al (2018) A dose-finding study for hemoporfin in photodynamic therapy for port-wine stain: a multicenter randomized double-blind phase II b trial. Photodermatol Photoimmunol Photomed 34(5):314–321. https://doi.org/10.1111/phpp.12384

    Article  CAS  PubMed  Google Scholar 

  18. Gu Y, Li J, Chen H et al (1992) A study of photodynamic therapy for port wine stains using chicken comb as a model. Chinese J Laser Med 1(2):81. https://doi.org/10.13480/j.issn1003-9430.1992.02.007

    Article  Google Scholar 

  19. Zhao Y, Tu P, Zhou G et al (2016) Hemoporfin photodynamic therapy for port-wine stain: a randomized controlled trial. PLoS One 11(5):e0156219. https://doi.org/10.1371/journal.pone.0156219

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Waelchli R, Aylett SE, Robinson K et al (2014) New vascular classification of port-wine stains: improving prediction of Sturge-Weber risk. Brit J Dermatol 171(4):861–867. https://doi.org/10.1111/bjd.13203

    Article  CAS  Google Scholar 

  21. Chen JK, Ghasri P, Aguilar G et al (2012) An overview of clinical and experimental treatment modalities for port wine stains. J Am Acad Dermatol 67(2):289–304. e29. https://doi.org/10.1016/j.jaad.2011.11.938

    Article  PubMed  PubMed Central  Google Scholar 

  22. Li X, Diao P, Liu L et al (2022) Hematoporphyrin monomethyl ether photodynamic therapy for the treatment of Sturge–Weber syndrome and large segmental facial port-wine stain. Dermatol Ther 35(5):e15404. https://doi.org/10.1111/dth.15404

    Article  CAS  PubMed  Google Scholar 

  23. Hagen SL, Grey KR, Korta DZ et al (2017) Quality of life in adults with facial port-wine stains. J Am Acad Dermatol 76(4):695–702. https://doi.org/10.1016/j.jaad.2016.10.039

    Article  PubMed  Google Scholar 

  24. Nguyen C, Yohn J, Huff C et al (1998) Facial port wine stains in childhood: prediction of the rate of improvement as a function of the age of the patient, size and location of the port wine stain and the number of treatments with the pulsed dye (585 nm) laser. Br J Dermatol 138(5):821–825. https://doi.org/10.1046/j.1365-2133.1998.02219.x

    Article  CAS  PubMed  Google Scholar 

  25. Lu Y-G, Wu J-J, Yang Y-D et al (2010) Photodynamic therapy of port-wine stains. J Dermatol Treat 21(4):240–244. https://doi.org/10.1080/09546630903200604

    Article  CAS  Google Scholar 

  26. Gu Y, Li J, Jiang Y et al (1992) A clinical study of photodynamic therapy for port wine stain-a report of 40 cases. Chinese J Laser Med (01):6–10. https://doi.org/10.13480/j.issn1003-9430.1992.01.003

    Article  Google Scholar 

  27. Zhang B, Zhang T-H, Huang Z et al (2014) Comparison of pulsed dye laser (PDL) and photodynamic therapy (PDT) for treatment of facial port-wine stain (PWS) birthmarks in pediatric patients. Photodiagn Photodyn Ther 11(4):491–497. https://doi.org/10.1016/j.pdpdt.2014.06.004

    Article  Google Scholar 

  28. Zhang M, Wu Q, Lin T et al (2020) Hematoporphyrin monomethyl ether photodynamic therapy for the treatment of facial port-wine stains resistant to pulsed dye laser. Photodiagn Photodyn Ther 31:101820. https://doi.org/10.1016/j.pdpdt.2020.101820

    Article  CAS  Google Scholar 

  29. Zhang L-C, Yang J, Huang Y-B et al (2022) Efficacy of hemoporfin photodynamic therapy for pulsed dye laser-resistant facial port-wine stains in 107 children: a retrospective study. Indian J Dermatol Venereol Leprol 88(2):275. https://doi.org/10.25259/IJDVL_976_20

    Article  PubMed  Google Scholar 

  30. Khalaf AT, Sun Y, Wang F et al (2020) Photodynamic therapy using HMME for port-wine stains: clinical effectiveness and sonographic appearance. Biomed Res Int 2020:6030581. https://doi.org/10.1155/2020/6030581

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Savas JA, Ledon JA, Franca K et al (2013) Pulsed dye laser-resistant port-wine stains: mechanisms of resistance and implications for treatment. Brit J Dermatol 168(5):941–953. https://doi.org/10.1111/bjd.12204

    Article  CAS  Google Scholar 

  32. Zhang X-Y, Al-Odaini N, Fan R-G et al (2022) The efficacy of hematoporphyrin monomethyl ether photodynamic therapy in adult patients with port-wine stains: a retrospective study. Dermatol Ther 12(4):861–869. https://doi.org/10.1007/s13555-022-00699-w

    Article  Google Scholar 

  33. Han Y, Yu W, Wang L et al (2022) Histological characteristics of port-wine stains with complete regression after photodynamic therapy treatment: a 7-year follow-up. Photobiomodul Photomed Laser Surg 40(3):159–162. https://doi.org/10.1089/photob.2021.0111

    Article  CAS  PubMed  Google Scholar 

  34. Liu L, Zhou L, Zhao Q et al (2022) Histological analysis of different types of port-wine stains to guide clinical decision making: a retrospective study. Indian J Dermatol Venereol Leprol:1–9. https://doi.org/10.25259/IJDVL_730_2021

  35. Lin Y, Gong W, Kang J et al (2022) Hemoporfin-mediated photodynamic therapy for port-wine stains: multivariate analysis of clinical efficacy and optical coherence tomography appearance. Front Med 9:9. https://doi.org/10.3389/fmed.2022.800836

    Article  Google Scholar 

  36. Zhang X-Y, Al-Odaini N, Zheng W-J et al (2022) The relationship between the effectiveness of HMME-PDT and the dermoscopic features of port-wine stains in Chinese pediatric patients: a retrospective study. Dermatol Ther 12(7):1671–1683. https://doi.org/10.1007/s13555-022-00757-3

    Article  CAS  Google Scholar 

  37. Xiao Q, Li Q, Yuan KH et al (2011) Photodynamic therapy of port-wine stains: long-term efficacy and complication in Chinese patients. J Dermatol 38(12):1146–1152. https://doi.org/10.1111/j.1346-8138.2011.01292.x

    Article  CAS  PubMed  Google Scholar 

  38. Yu W, Ma G, Qiu Y et al (2016) Why do port-wine stains (PWS) on the lateral face respond better to pulsed dye laser (PDL) than those located on the central face? J Am Acad Dermatol 74(3):527–535. https://doi.org/10.1016/j.jaad.2015.08.026

    Article  PubMed  Google Scholar 

  39. Walker EP, Butler PH, Pickering JW et al (1989) Histology of port wine stains after copper vapour laser treatment. Brit J Dermatol 121(2):217–223. https://doi.org/10.1111/j.1365-2133.1989.tb01801.x

    Article  CAS  Google Scholar 

  40. Kelly KM, Kimel S, Smith T et al (2004) Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels. Laser Surg Med 34(5):407–413. https://doi.org/10.1002/lsm.20041

    Article  Google Scholar 

  41. Chun-Hua T, Li-Qiang G, Hua W et al (2021) Efficacy and safety of hemoporfin photodynamic therapy for port-wine stains in paediatric patients: a retrospective study of 439 cases at a single centre. Photodiagn Photodyn 36:102568. https://doi.org/10.1016/j.pdpdt.2021.102568

    Article  CAS  Google Scholar 

  42. Hu D et al (2022) Retrospective analysis of Hemoporfin-mediated photodynamic therapy in the treatment of naïve port-wine stains. Photodiagn Photodyn 39:103003. https://doi.org/10.1016/j.pdpdt.2022.103003

    Article  CAS  Google Scholar 

  43. Odaci E S B. Face embryology. http://emedicine.medscape.com/article/844962-overview. Accessed 27 March 2023

  44. Tan W, Chernova M, Gao L et al (2014) Sustained activation of c-Jun N-terminal and extracellular signal-regulated kinases in port-wine stain blood vessels. J Am Acad Dermatol 71(5):964–968. https://doi.org/10.1016/j.jaad.2014.07.025

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Shirley MD, Tang H, Gallione CJ et al (2013) Sturge–Weber syndrome and port-wine stains caused by somatic mutation in GNAQ. N Engl J Med 368(21):1971–1979. https://doi.org/10.1056/NEJMoa1213507

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was funded by Natural Science Basic Research Program of Shaanxi (2023-JC-YB-787) to Weihui Zeng. National Natural Science Foundation of China (NSFC) (82201966) and Natural Science Basic Research Program of Shaanxi (2023-JC-QN-0924) to Zhao Wang.

Author information

Authors and Affiliations

  1. Department of Dermatology, Second Affiliated Hospital of Xi’an Jiaotong University, 157 Xiwu Road, Xi’an, 710004, China

    Zhu Min, Liu Jing, Zhou Jun, Qiao Simeng, Wang Zhaoyang, Wang Zhao & Zeng Weihui

Authors
  1. Zhu Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liu Jing
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhou Jun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qiao Simeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wang Zhaoyang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wang Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zeng Weihui
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Design: ZWH. Experiments: ZM, LJ, ZJ, QSM, WZY. Data analysis/writing: ZM, QSM, WZY. Manuscript revision: LJ, WZ, ZWH. Supervision: ZWH, LJ, WZ. Funding acquisition: ZWH, WZ. All the authors approved this final version.

Corresponding author

Correspondence to Zeng Weihui.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Min, Z., Jing, L., Jun, Z. et al. Influential Factors in the Efficacy of Hemoporfin-Mediated Photodynamic Therapy for Port-wine Stains. Lasers Med Sci 38, 162 (2023). https://doi.org/10.1007/s10103-023-03822-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10103-023-03822-1

Keywords

Search

Navigation