Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port wine stain birthmarks

Tournas, Joshua A.; Lai, Jennifer; Truitt, Anne; Huang, Y.C.; Osann, Kathryn E.; Choi, Bernard; Kelly, Kristen M.

doi:10.1016/j.pdpdt.2009.10.002

« Previous Next »Photodiagnosis and Photodynamic Therapy
Volume 6, Issue 3 , Pages 195-199, September 2009

Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port wine stain birthmarks

Joshua A. Tournas
- Beckman Laser Institute, University of California, Irvine, CA, United States
- Department of Dermatology, University of California, Irvine, CA, United States
Jennifer Lai
- Beckman Laser Institute, University of California, Irvine, CA, United States
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
Anne Truitt
- Beckman Laser Institute, University of California, Irvine, CA, United States
- Department of Dermatology, University of California, Irvine, CA, United States
Y.C. Huang
- Beckman Laser Institute, University of California, Irvine, CA, United States
Kathryn E. Osann
- Department of Medicine, University of California, Irvine, CA, United States
Bernard Choi
- Beckman Laser Institute, University of California, Irvine, CA, United States
- Department of Surgery, University of California, Irvine, CA, United States
- Department of Biomedical Engineering, University of California, Irvine, CA, United States
Kristen M. Kelly, MD
- Beckman Laser Institute, University of California, Irvine, CA, United States
- Department of Dermatology, University of California, Irvine, CA, United States
- Department of Surgery, University of California, Irvine, CA, United States
- Corresponding author at: 1002 Health Sciences Road East, Irvine, CA 92612, United States. Tel.: +1 949 824 7997; fax: +1 949 824 2726.

published online 13 November 2009.

Summary

Background

Pulsed dye laser (PDL) is a commonly utilized treatment for port wine stain birthmarks (PWS) in the United States; however, results are variable and few patients achieve complete removal. Photodynamic therapy (PDT) is commonly used in China, but treatment associated photosensitivity lasts several weeks and scarring may occur. We propose an alternative treatment option, combined PDT+PDL and performed a proof-of-concept preliminary clinical trial.

Methods

Subjects with non-facial PWS were studied. Each subject had four test sites: control, PDL alone, PDT alone (benzoporphyrin derivative monoacid ring A photosensitizer with 576nm light), and PDT+PDL. Radiant exposure time for PDT was increased in increments of 15J/cm². Authors evaluated photographs and chromametric measurements before and 12 weeks post-treatment.

Results

No serious adverse events were reported; epidermal changes were mild and self-limited. No clinical blanching was noted in control or PDT-alone sites. At PDT radiant exposures of 15 and 30J/cm², equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30J/cm², greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75J/cm², improved blanching was noted at PDT+PDL sites.