[Clinical study of 1949 cases of port wine stains treated with vascular photodynamic therapy (Gu's PDT)].

BACKGROUND: Complete fading of port wine stains (PWS) is difficult to achieve with current laser treatments. Photodynamic therapy (Gu's PDT) could offer a very efficient alternative for PWS therapy.

PATIENTS AND METHOD: 1949 lesions in 1385 patients were treated by PDT. Each patient received an intravenous injection of hematoporphyrin derivative (HpD) or hematoporphyrin monomethyl ether (HMME) at 3-7 mg/kg. Laser irradiation was performed on a 2 to 8 cm spot size. Different wavelengths (488.0 nm to 578.2 nm) were evaluated with a power density of 50-100 mW/cm2. Fluences ranged from 90 to 540 J/cm2.

RESULTS: Among the 1942 lesions, PWS clearance was observed in 99.7% of cases. Excellent results were achieved in 128 lesions (6.6%) (100% clearance), 746 lesions (38.3%) yielded to good results (clearance > 75%), 923 lesions (47.4%) showed moderate results (clearance 50-75%), 145 lesions (7.4%) showed poor results (clearance<50%) and in 7 lesions (0.3%) no visible change was observed. The pink port wine stains revealed better response to Gu's PDT with only one session. Conversely, purple stains in adult patients required 2 sessions or more.

CONCLUSION: This new PDT technique is effective and highly selective, with almost no risk of scarring.