Combined Benzoporphyrin Derivative Monoacid Ring A Photodynamic Therapy and Pulsed Dye Laser for Port Wine Stain Birthmarks

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 576 nm light), and PDT+PDL. Radiant exposure time for PDT was increased in increments of 15 J/cm2. Authors evaluated photographs and chromametric measurements before and 12 weeks posttreatment. 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 30 J/cm2, equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30 J/cm2, greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75 J/cm2, improved blanching was noted at PDT+PDL sites. Conclusions—Preliminary results indicate that PDT+PDL is safe and may offer improved PWS treatment efficacy. Additional studies are warranted. © 2009 Elsevier B.V. All rights reserved. Corresponding Author: Kristen M. Kelly, M.D., 1002 Health Sciences Road East, Irvine, CA 92612, Telephone: (949) 824-7997, Fax: (949) 824-2726, [email protected]. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Photodiagnosis Photodyn Ther. Author manuscript; available in PMC 2010 November 12. Published in final edited form as: Photodiagnosis Photodyn Ther. 2009 ; 6(3-4): 195–199. doi:10.1016/j.pdpdt.2009.10.002. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript