Comparison of photodynamic therapy and pulsed dye laser in patients with port wine stain birthmarks: a retrospective analysis

Abstract

Background: Photodynamic therapy (PDT) might be an alternative approach for treating port wine stains (PWS). This study attempts to compare clinical outcomes of PDT versus conventional pulsed dye laser (PDL) in Chinese patients.

Methods: Retrospective analysis of medical records of a single hospital. PDL was delivered by a 585 nm laser. PDT was carried out by a combination of hematoporphyrin monomethyl ether (HMME) and copper vapour laser (510.6 and 578.2 nm). Clinical outcomes were graded based on photographs.

Results: The children group (3-10 years old) included 210 patients (PDL=112 and PDT=98) with pink flat PWS located in the cheek region. The overall fair to excellent response was 95.5% in PDL group and 88.8% PDT group (P=0.901), respectively. The excellent response rate of PDT group (23.5%) was higher than that of PDL group (16.1%). The adult group (18-30 years old) included 371 patients (PDL=163 and PDT=208) with purple flat PWS located in the temple, cheek or neck region. The overall fair to excellent response in PDL and PDT group was 88.4 and 94.2% (P<0.001), respectively. The excellent response rate of PDT group (37.5%) was significantly higher than that of PDL group (3.1%). The complication rate (pigmentary or textural change) in PDT group (10.2%) was lower than that in PDL group (24.7%).

Conclusions: PDT is as effective as PDL for pink flat lesions and is more effective than PDL for purple flat lesions. The true value of PDT deserves further investigation.