Efficacy and safety of hemoporfin photodynamic therapy for port-wine stains in paediatric patients: a retrospective study of 439 cases at a single centre.

BACKGROUND Although hemoporfin phototherapy is a promising treatment approach for port-wine stains, its efficacy in children has not been sufficiently assessed. We aimed to evaluate the efficacy and safety of this approach in a paediatric population. METHODS We retrospectively analysed the medical records of 439 children with port-wine stains receiving hemoporfin photodynamic therapy at our institution from July 2017 to January 2020. They received intravenous hemoporfin (hematoporphyrin monomethyl ether, 5 mg/kg), followed by lesion irradiation with a 532-nm green LED light for 20-25 minutes. The stains' blanching degree and occurrence of adverse events were registered. RESULTS Overall, 95.2% of patients showed an 'effective response' (>20% fading) and 74.3% showed almost-complete resolution and great improvement (≥60% fading). Red and pink lesions showed better response than purple lesions (P<0.05). Neck and facial lesions showed better response than the trunk and extremity lesions (P<0.05). The response of the patients to the PDT showed a cumulative effect of the treatment session. No photosensitivity or systemic adverse reactions were observed. Transient local adverse effects included swelling, purpura, crusts, and pigmentation, which resolved without treatment. Only 2% of children had permanent scars, likely related to scratching crusts. CONCLUSIONS Hemoporfin photodynamic therapy was well tolerated and effective in paediatric Chinese patients with port-wine stains. It should be recommended as the first choice, over pulsed-dye laser therapy, for treating port-wine stains, particularly for large lesions.