Noninvasive Diagnosis Revealed a Strong Therapeutic Response and Skin Barrier Changes in Hemoporfin‐Mediated Photodynamic Therapy for Port‐Wine Stains

BACKGROUND: Noninvasive skin imaging, such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), has been extensively used to collect objective clinical data and assess the morphological and ultrastructural change of tissue. However, the application of these noninvasive diagnosis techniques for the therapeutic evaluation of hemoporfin-mediated photodynamic therapy (HMME-PDT) in port-wine stains (PWS) has rarely been reported. OBJECTIVES: To explore the clinical efficacy of HMME-PDT for PWS, and assess the application of RCM and OCT in objective assessment of the efficacy of HMME-PDT. METHODS: Clinical images, RCM findings, and OCT scans were used to evaluate the treatment efficacy. The vascular diameter and density under RCM findings, the vascular density, and depth of OCT scans were used for objective therapeutic evaluation. Skin surface roughness and barrier functions were used to analyze the skin barrier changes. RESULTS: After PDT treatment, the clinical pictures showed excellent improvements, and the RCM findings revealed significantly decreased vascular diameter (100.0 ±2.450 vs. 59.61± 4.021, p<0.05) and density (16.79 ± 0.6568 vs. 10.91 ± 0.8052) in treated areas. Moreover, the OCT scans further confirmed the decrease in vascular density and depth, and the skin surface roughness of Ra (arithmetic mean), Rz (the average depth of roughness), Rq (the mean square roughness) and the skin barrier function of transepidermal water loss (TEWL), stratum corneum hydration (SCH), and potential of hydrogen (pH) of these treated areas all were significantly changed (p < 0.05). CONCLUSIONS: HMME-PDT is an effective and safe treatment option for PWS patients, and noninvasive diagnosis combined with clinical images are excellent techniques for objectively evaluating efficacy of HMME-PDT.