Effectiveness and safety of hematoporphyrin monomethyl ether-mediated photodynamic therapy versus pulsed dye laser for port-wine stain: a retrospective study.

Abstract

Hematoporphyrin monomethyl ether-mediated photodynamic therapy (HMME-PDT) is an emerging treatment for port-wine stain (PWS). To compare the effectiveness and safety of HMME-PDT with pulsed dye laser (PDL) for PWS on the face and neck. A retrospective study was conducted comparing 728 patients treated with HMME-PDT and 655 with PDL. Logistic regression was used to assess effectiveness. An excellent improvement was defined as ≥75% lesion clearance. Before adjustment, 41.5% of patients showed excellent improvement after a median of 2 HMME-PDT sessions, and 29.2% after a median of 3 PDL sessions. After adjusting for confounders, the HMME-PDT group was more likely to achieve excellent improvement (OR: 2.90, 95% CI: 2.02-4.15, P < 0.05) than the PDL group. Effectiveness was primarily influenced by lesion size, thickness, number of treatment sessions, and prior treatment. HMME-PDT showed higher incidences of hyperpigmentation (5.4% vs. 1.8%, P < 0.05) and scarring (3.3% vs. 0.5%, P < 0.05) than PDL. The retrospective design and lack of long-term follow-up. HMME-PDT showed superior effectiveness than PDL for treating facial and neck PWS, but it carried a higher risk of hyperpigmentation and scarring.