Clinical comparison between photodynamic therapy and pulsed dye laser for the treatment of port wine stains

Abstract

Objective To compare the clinical efficacy and adverse effects of photodynamic therapy(PDT)versus pulsed dye laser(PDL)for the treatment of port wine stains(PWS). Methods Forty-five patients with PWS were enrolled in this study. The PWS lesions in each patient were randomly divided into PDT and PDL areas. Hematoporphyrin monomethyl ether of 5 mg/kg was injected intravenously into the PDT area protected from light, followed by 20-minute irradiation with a 532-nm, solid-state, continuous-wave laser(power density: 80-100 mw/cm2; spot diameter: 7 cm)10 minutes later. The PDL area was treated with a single session of 595-nm pulsed dye laser radiation(spot diameter: 7 mm; pulse width: 10 ms; energy density: 10-12 J/cm2). The interval between PDT and PDL treatment was no shorter than two months. Follow up visits were scheduled on day 4 and week 8 after each treatment. Adverse reactions were recorded, and photographs were taken before and 8 weeks after the treatment for evaluation of lesion regression. Results In the case of PDT area, 10 cases(22.22%)were nearly cured, 22(48.89%)achieved marked improvement, 9(20.00%)improvement, 4(8.89%)no improvement. As far as the PDL area is concerned, 6 cases(13.33%)were nearly cured, 16(35.56%)achieved marked improvement, 18(40.00%)improvement, and 5(11.11%)no improvement. The response rate was significantly higher in the PDT area than in the PDL area(Z = 2.48, P 0.05). Conclusion For the treatment of PWS, both PDT and PDL are effective and safe, and single-session PDT appears to be superior to single-session PDL. Key words: Port-wine stain; Phototherapy; Hematoporphyrin photoradiation