The Relationship Between the Effectiveness of HMME-PDT and the Dermoscopic Features of Port-wine Stains in Chinese Pediatric Patients: A Retrospective Study

Zhang, Xinyu; Al-Odaini, Najwa; Zheng, Wenjun; Fan, Runge; Xiong, Hong-di; Huang, Jia-Can; Dai, Hong-Mei; Zhou, Yan; Huang, Xiu-yin; Cao, Cunwei; Wen, Sijian

doi:10.1007/s13555-022-00757-3

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…According to the title and abstract of the studies, we screened 512 studies after eliminating duplicates. Then, 26 studies were chosen after reading the full texts of 35 articles ( 11 , 12 , 15 – 38 ) ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“… cm 2 , square centimeter; HMME, hematoporphyrin monomethyl ether; IDAS, ist das leistungsstarke, transportable LBO-laser system; J/cm 2 , joule per square centimeter; KTP laser, potassium titanyl phosphate laser; LED light, light emitting diode; Mg/kg, milligrams per kilogram; min, minute; Nm, nanometer; Nd:YAG laser, neodymium-doped yttrium aluminum garnet laser; PC, prospective cohort; PDL, pulsed dye laser; PsD-007, photocarcinorin; PWS, port wine stain; RAC, retrospective analytic cohort; RCT, randomized controlled trial; RS, retrospective study; –, not reported. Zhang et al ( 12 ) (A), subjects: adult patients; Zhang et al ( 38 ) (C), subjects: children patients. …”

Section: Resultsmentioning

confidence: 99%

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Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Huang

2023

Front. Med.

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BackgroundPort wine stains (PWS) often cause cosmetic effects and psychological distress. Pulsed dye lasers (PDL) and photodynamic therapy (PDT) are the most commonly used treatments. PDL is still the “gold standard” of therapy to date. However, its shortcomings have become apparent as clinical applications have increased. PDT has been proven as an alternative to PDL. Patients with PWS still lack enough evidence about PDT to make informed treatment decisions.ObjectiveThe purpose of this systematic review and meta-analysis was to assess the safety and effectiveness of PDT for PWS.MethodsThe online datasets, comprising PubMed, Embase, Web of Science, and the Cochrane Library, were searched for meta-analysis-relevant publications. Two reviewers separately evaluated the risk of bias in each listed study. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the treatment and safety outcomes.ResultsOur search retrieved 740 hits and only 26 studies were finally included. Among the 26 studies included, 3 were randomized clinical trials, and 23 were prospective or retrospective cohort investigations. Based on a gathered assessment, the percentage of individuals achieving a 60% improvement was estimated to be 51.5% [95% confidence interval (CI): 38.7–64.1; I2 = 83.8%] and a ≥75% improvement was 20.5% (95% CI: 14.5–26.5; I2 = 78.2%) after 1–8.2 treatment sessions (GRADE score: very low). Due to the statistical diversity of the meta-analysis, a subgroup assessment was performed to determine the sources of diversity. The collected findings indicated that the impact of PDT on enhancing the medical effectiveness of PWS was significant in different treatment sessions, different types of ages, different locations of PWS, and different types of PWS. Pain and edema occurred in most patients. Hyperpigmentation was present in 7.9–34.1% of the patients in 17 studies. Photosensitive dermatitis, hypopigmentation, blister, and scar were infrequently reported, with 0–5.8% incidences.ConclusionPhotodynamic therapy is recommended as a safe and effective treatment for PWS based on the current evidence. However, our findings are based on poor-quality evidence. Therefore, comparative investigations of a large scale and high quality are necessary to support this conclusion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Huang

2023

Front. Med.

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“…Dotted and globular vessels, short clubbed vessels, and curved vessels, are characterized by a clean background and well-defined reddish vascular morphology. 24 These vessels may be located in the upper third of the dermis, are superficial and perpendicular to the skin with no dense proliferation of collagen fibers, and have relatively thin-vessel walls. 22 , 23 HMME-PDT can more easily destroy or remove deformed vessels that are superficial to the location.…”

Section: Effect Evaluationmentioning

confidence: 99%

“…12,21 Dermoscopy patterns were mixed vessels and a grey-whitish veil, characterized in a hazy red background with badly defined vessels, which not only are associated with a larger diameter and thicker blood vessel wall, but also with dense collagen fibers in the deeper dermis, the thicker vessel walls and the dense collagen fibers can block the energy of the light source. [21][22][23][24] The reticular vascular patterns under dermoscopy may represent a large number of parallel or crossarranged vessels in the deeper dermis, and these malformed vascular structures are not easily penetrated by HMME-PDT light source. 22,23 Therefore, the presentation of these three vascular patterns suggests the lower effect of HMME-PDT.…”

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confidence: 99%

Hematoporphyrin Monomethyl Ether Photodynamic Therapy of Port Wine Stain: Narrative Review

Diao¹,

Han²,

Li³

et al. 2023

CCID

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Port wine stain (PWS) is a congenital and progressive capillary malformation characterized by structural abnormalities of intradermal capillaries and postcapillary venules. The visible manifestation is often considered a disfigurement and the accompanying social stigma often causes serious emotional and physical impact. Hematoporphyrin monomethyl ether (HMME) is a newly authorized photosensitizer for treating PWS in China. Hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT) has successfully treated thousands of Chinese patients with PWS since 2017, and HMME-PDT may be one of the most promising strategies for the treatment of PWS. However, there are few reviews published about the clinical use of HMME-PDT. So in this article, we want to briefly review the mechanism, efficacy evaluation, effectiveness and influencing factors, and the common postoperative reactions and treatment suggestions of HMME-PDT in the treatment of PWS.

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“…It is a safe and effective modality for managing a wide range of cutaneous conditions, including vascular and pigmented lesions, tattoos, scars, and unwanted hair. Moreover, several clinical trials have shown the potential use of IPL as a light source for photodynamic therapy (PDT) [2][3][4][5]. PDT is a non-invasive medical treatment that utilizes a combination of light-sensitive photosensitizing agents and specific wavelengths of light to selectively target and destroy abnormal cells or tissues.…”

Section: Introductionmentioning

confidence: 99%

In vivo study of photodynamic effect induced by combination of IPL and HMME

Peng,

Guo,

Zhan

et al. 2023

Optics in Health Care and Biomedical Optics XIII

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Intense pulsed light (IPL) is an incoherent high-intensity pulsed light used in various dermatological and cosmetic procedures. Early studies suggest that IPL might be used in photodynamic therapy (PDT). HMME is a 2 nd generation photosensitizer and used for PDT of portwine stain birthmarks. The aim of this study was to investigate the feasibility of combination of IPL and HMME. The skin and ear of ICR mice were irradiated with IPL in the absence or present of HMME. Morphological changes and thickness variations were assessed pre and post-irradiation. Compared to IPL alone, the addition of HMME significantly worsened the light damages. This indicated that IPL could facilitate HMME mediated photodynamic effects in mouse skin tissues. It might be feasible to use IPL as a PDT light source.

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The Relationship Between the Effectiveness of HMME-PDT and the Dermoscopic Features of Port-wine Stains in Chinese Pediatric Patients: A Retrospective Study

Cited by 9 publications

References 27 publications

Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Efficacy of photodynamic therapy in the treatment of port wine stains: A systematic review and meta-analysis

Hematoporphyrin Monomethyl Ether Photodynamic Therapy of Port Wine Stain: Narrative Review

In vivo study of photodynamic effect induced by combination of IPL and HMME

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