Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks

作者：Chao Gao, Vi Nguyen, Marcelo Hochman, Lin Gao, Elliott H. Chen, Harold I. Friedman, J. Stuart Nelson, Wenbin Tan · 发表于：Lasers in Surgery and Medicine · 年份：2024 · DOI：10.1002/lsm.23779 · 被引用次数：14 · 研究领域：Dermatologic Treatments and Research、Photodynamic Therapy Research Studies、Oral and Craniofacial Lesions

Abstract Background Port wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the “gold standard” for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)‐mediated photodynamic therapy (HMME–PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades. Aim To evaluate whether HMME–PDT is superior to PDL by comparing the clinical efficacies of both modalities. Method PubMed records were searched for all relevant studies of PWB treatment using PDL (1988−2023) or HMME–PDT (2007−2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C 0 ), with data weighted by cohort size, was used to evaluate the final efficacy for each modality. Result A total of 18 HMME–PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME‐PDT studies were minors (<18 years old). A significant portion (21.3%) were young children (<3 years old). Similarly, 33.2% of patients in the PDL studies were minors. A small proportion (9.3%) was young children. The overall cl...