Photodynamic therapy of port wine stains-a report of 238 cases

摘要

Objective: Retrospective analysis of clinical effects of vascular acting photodynamic therapy (PDT) for the treatment of port wine stains (PWS). Methods: Between September 1997 and June 2003, a total of 238 PWS cases (2-56 years old) were treated with Photocarcinorin-mediated PDT using a copper vapour laser. Among them, 20 cases were pink lesions (Type Ⅰ), 44 cases red lesions (Type Ⅱ), 99 cases dark red lesions (Type Ⅲ), 51 cases purple lesions (Type Ⅳ), and 24 cases nodular or thickened lesions (Type Ⅴ), respectively. Patient received a slow intravenous injection of Photocarcinorin (4-5 mg/kg b.w.) and light was delivered during the drug injection at dose levels of 160-260 J/cm~2 at fluence rates of 70-100 mW/cm~2. The same procedure was repeated 2-4 times for some patients. All patients were followed up for 6 months to 4 years. Results: Sixty-eight cases (28.6%) showed excellent response, 76 cases (31.9%) good response, 87 cases (36.6%) fair response and 7 cases (2.9%) poor or no response. Secondary scar formation was reported in three cases. Highest good to excellent response rates were seen in patients of 5-20 years old. PDT-induced transitional hyperpigmentation was reported in some patients but disappeared without the need of treatment within 3-6 months. Conclusion: Copper vapour laser PDT can selectively destroy PWS vessels without damage to the normal skin. If the technique is applied properly, it can cure superficial lesions and greatly improve thick lesions.