Comparative Study Of Clinical Efficacy Of Hemoporfin Photodynamic Therapy And Pulsed Dye Laser In The Treatment Of Port-wine Stains

ObjectiveCompare the clinical efficacy and safety of 595 nm pulsed dye laser(595nm PDL)and hemoporfin(chemical name hematoporphyrin monomethyl ether(HMME))photodynamic therapy(PDT)in the treatment of port-wine stains(PWS)in the same period.MethodCollection of patients with port-wine stains treated in our laser beauty center from January 2017 to June 2019.Among them,300 cases of them underwent 595 nm pulsed dye laser treatment,46 cases were treated with hemoporfin photodynamic therapy.The595 nm pulsed dye laser treatment group is given the next treatment every 4 weeks,and the hemoporfin photodynamic therapy treatment group is given the next treatment every8 weeks.Photographs of skin lesions and related information before and after each treatment were collected,and the influencing factors and adverse effects of the two treatment methods were analyzed,and the clinical efficacy and safety of patients under different treatment methods were compared.ResultsA total of 300 patients were treated with 595 nm pulsed dye laser,of which the total effective rate was 65.33%.There were 56 patients with pink lesion type and the effective rate was 80.36%.There were 192 patients with bright red lesion type.The effective rate was 65.63%.There were 37 patients with purple-red skin lesions,with an effective rate of 40.54%.There were 15 patients with hyperplastic skin lesions,with an effective rate of 66.67%.55 patients had hyperpigmentation after laser surgery,the incidence was 18.33%,55 cases of hypopigmentation occurred,the incidence rate was18.33%,and 7 cases of atrophic scar appeared,the incidence rate was2.33%.Hemoporfin photodynamic therapy for a total of 46 patients,with a total effective rate of 76.09%;a total of 5 patients with pink skin lesions,an effective rate of80.00%;a total of 16 patients with bright red lesions The effective rate was 93.75%;21patients with skin lesion type were reddish,with an effective rate of 61.90%;4 patients with skin lesion type were proliferative,with an effective rate of 75.00%;hyperpigmentation occurred after laser surgery 24 cases,the incidence was 52.17%,and all patients did not have hypopigmentation and atrophic scars.The effect of 595 nm pulsed dye laser treatment is related to the type of skin lesions,the number of treatments,and the location of the skin lesions.The skin lesions are pink,the number of treatments is more than 3 times,and the patients with skin lesions in the neck are more effective.However,the differences in efficacy caused by age and gender were statistically insignificant.The hypopigmentation and hyperpigmentation caused by the 595 nm pulsed dye laser need to wait for the skin to recover slowly,the incidence of scars is low,and the safety is good.The efficacy of hemoporfin photodynamic therapy is affected by the number of treatments.The more treatments,the more obvious the effect.At present,no treatment resistance has been observed.The age,gender,type of skin lesions,and location of the lesions on HMME-PDT,there is no statistical difference in the effect of treatment,and under the same treatment interval and the same type of skin lesions,we have observed that patients treated with HMME-PDT are more effective,but there is no statistical difference between the two.In terms of academic significance,these may be related to the small sample size,in addition,we observed that HMME-PDT has a good effect on extremity skin lesions.Hemoporfin photodynamic therapy is associated with hypopigmentation and scarring.Hypopigmentation and scarring caused by hemoporfin photodynamic therapy are rare,but due to the photosensitivity of the photosensitizer,the risk of hyperpigmentation is higher than that of the 595 nm pulsed dye laser.Conclusion595nm pulsed dye laser has higher efficiency in the treatment of port-wine stains,but the cure rate is lower,and it is not effective for some patients.In comparison,hemoporfin photodynamic therapy was more effective for patients with darker color,hypertrophy,and lesions in the extremities.Adverse reactions caused by 595 nm pulsed dye laser,including hypopigmentation,hyperpigmentation and scarring,have a low incidence,and the hemoporfin photodynamic therapy can easily lead to hyperpigmentation in the skin lesions,with a very low risk of hypopigmentation and scarring.Both of the two therapies have good efficacy and safety in clinical treatment.