Current Treatment Options for Port Wine Stain Birthmarks.
Current Treatment Options for Port Wine Stain Birthmarks.
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DOI：
10.1016/j.pdpdt.2007.05.002
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发表时间：
2007-09
影响因子：
3.3
通讯作者：
K. Kelly
中科院分区：
文献类型：
--
作者：
K. Kelly
我为秦等人鼓掌。发表《光动力疗法治疗葡萄酒色斑--238例报告》1.光动力疗法(PDT)治疗葡萄酒色斑(PWS)的丰富经验令人印象深刻，我相信在西方世界是无与伦比的。在美国和欧洲，脉冲激光和光源，特别是脉冲染料激光(PDL；波长=585或595 nm)是PWS的首选治疗方法，使用其他治疗方法是不寻常的2。然而，熟悉PDL疗法的医生同意，虽然PWS可以取得显著的效果，但许多病变是耐药的，完全切除是罕见的。老年患者(非婴儿)和皮肤类型较深的患者的皮损尤其难以治疗。证实了中国医生十多年来就知道的，PDT是一种成功程度很高的替代选择，可以被认为是一些PWS患者的首选治疗方案。报道的应答率与PDL治疗的有效率相似。然而，只需要1-4次治疗(PWS的PDL治疗通常需要6次或更多次治疗)。作者指出，在5-20岁的患者中取得了最大的成功。光剂量治疗在5岁以下的患者中更加困难，疤痕更常见。这与PDL治疗形成对比，据报道，PDL治疗的皮损减轻程度最大的是年轻患者3。还需要进一步的研究，但当5岁以下的患者开始治疗时，PDL治疗可能是最佳选择，PDT是5岁及以上患者的选择。
I applaud Qin et al. for their publication,“Photodynamic therapy of port wine stains–a report of 238 cases” 1. Such extensive experience with photodynamic therapy (PDT) for port wine stains (PWS) is impressive and I believe, unequaled in the Western world. In the United States and Europe, pulsed lasers and light sources, especially the pulsed dye laser (PDL; wavelengths= 585 or 595 nm) are the treatment of choice for PWS and it is unusual for other treatment modalities to be utilized 2. However, physicians familiar with PDL therapy for PWS agree that while dramatic results can be achieved, many lesions are resistant and complete removal is uncommon. Lesions in older patients (non-infants) and in those with darker skin types are particularly difficult to treat.This report by Qin et al. confirms what Chinese physicians have known for a decade or more, PDT is an alternative option with a significant degree of success, and could be considered the treatment option of choice for some PWS patients. Response rates reported are similar to those associated with PDL therapy. However, only 1–4 treatments were required (PDL treatment for PWS generally requires 6 or more treatments). The authors note that the greatest success was achieved in patients 5–20 years old. Light dosing was more difficult and scarring more common in those under 5. This is in contrast to PDL therapy, where the greatest lesion lightening has been reported in young patients 3. Further research is required, but perhaps PDL treatment is optimal when therapy is begun in those under 5 years, with PDT being an option for those 5 and older.