Abstract
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.