title: Combined benzoporphyrin derivative monoacid ring photodynamic therapy and pulsed dye laser for port wine stain birthmarks.
abstract: 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/cm(2). 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 30 J/cm(2), equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30 J/cm(2), greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75 J/cm(2), 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.
authors.affiliation: Beckman Laser Institute, University of California, Irvine, CA 92612, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Tournas
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lai
authors.forename: Anne
authors.initials: A
authors.lastname: Truitt
authors.forename: Y C
authors.initials: YC
authors.lastname: Huang
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Osann
authors.forename: Bernard
authors.initials: B
authors.lastname: Choi
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Kelly
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use*; D019339:Port-Wine Stain / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome; D000077362:Verteporfin; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin