Abstract
BACKGROUND: Hemoporfin-mediated photodynamic therapy (HMME-PDT) is an effective and safe therapeutic modality for port wine stains (PWS). However, the clinical efficacy is influenced by multiple factors. This study aimed to evaluate the efficacy of HMME-PDT for children with PWS who have a prior history of pulsed dye laser (PDL) treatment. METHODS: Clinical data were collected from children with PWS who received HMME-PDT treatment. The patients were divided into two groups: patients without PDL treatment history as the No PDL group and patients with a history of PDL as the Prior PDL group. The correlations between clinical efficacy and gender, age, lesion location, lesion color, dermoscopic vascular features, and number of treatments were analyzed in children with PWS. RESULTS: A total of 216 patients were enrolled, including 100 patients in the No PDL group and 116 patients in the Prior PDL group aged between 1 and 14 years. There was no significant difference in clinical efficacy and adverse reactions of HMME-PDT treatment between the No PDL and Prior PDL groups. Both the location of lesions and dermoscopic vascular features significantly influenced the clinical efficacy of HMME-PDT for children with PWS (p < 0.05), while gender, age, lesion color, and number of treatments showed no association with the clinical efficacy. The location of lesions and dermoscopic vascular features might be an independent influencing factor for the clinical efficacy of HMME-PDT in children with PWS (p < 0.05). CONCLUSION: These data indicated that PDL treatment history did not influence the clinical efficacy of HMME-PDT and supported HMME-PDT as an alternative means to treat PDL-resistant PWS in children.