Early Recognition of the Gray-White Sign Prevents Scarring After Hemoporfin-Mediated Photodynamic Therapy in Pediatric Port Wine Capillary Malformations: A Case Series

作者：Huang XW, Cheng SQ, Zheng SQ, Chen BH, Chen PJ, Li Q, Guo J, Zhu MH, He SJ, Zheng Y · 发表于：Lasers in surgery and medicine · 年份：2026 · DOI：10.1002/lsm.70200 · 研究领域：hemoporfin、pediatric patients、photodynamic therapy、port‐wine capillary malformations、scarring

BACKGROUND: Hemoporfin-mediated photodynamic therapy (HMME-PDT) is one of the primary treatment modalities for pediatric patients with port wine capillary malformations (port wine CMs) in China. However, it carries a substantial scarring formation risk, particularly in children with delicate skin. Current clinical practice primarily focuses on intraoperative parameter optimization, while postoperative management often remains passive. OBJECTIVES: To highlight the clinical significance of early postoperative signs indicative of impending scarring based on empirical experience, and to emphasize the critical role of early recognition and timely intervention. METHODS: Based on our experience with approximately 3550 pediatric patients undergoing HMME-PDT since 2017, we retrospectively analyzed 15 representative cases to evaluate the clinical course and management outcomes of high-risk signs. Clinical data, photographic documentation, and management outcomes were evaluated to identify key risk factors of scarring and effective interventions. RESULTS: Among the 33 patients (1%) who developed scarring, approximately 88% (29/33) exhibited rapid darkening or gray-white discoloration prior to scar formation. Immediate intervention with topical corticosteroids under occlusion reversed this sign within 72 h. At the median follow-up of 2 months, significant improvement of the original lesions and no scars formation were observed. However, a reference case with only basic wound care resu...