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Shi MD, Yang K, Li SB, Zhao Q, Huo R, Fu C. Complication rates and safety of pulsed dye laser treatment for port-wine stain: a systematic review and meta-analysis. Lasers Med Sci 2023; 39:16. [PMID: 38141129 DOI: 10.1007/s10103-023-03961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Pulsed dye laser (PDL) is the most commonly used method for port-wine stain (PWS); however, no studies have reported the safety of PDL. This review aimed to collect and summarize complications reported in relevant literature, assess complication rates in treating PWS with PDL, and explore the relevant influencing factors. A systematic review and meta-analysis were conducted to search for related studies in PubMed, Embase, and the Cochrane Library until August 2022. Two reviewers independently evaluated the risk of bias of included studies. Stata Software version 17.0 was used for the analysis. All complications reported in the literature are divided into acute phase complications and long-term complications. Overall pooled purpura, edema, crusting, blistering, hyperpigmentation, hypopigmentation, and scarring rates were 98.3%, 97.6%, 21.5%, 8.7%, 12.8%, 0.9%, and 0.2%, respectively. Although the acute adverse reactions were found to be common, the long-term permanent complications clearly have a lower frequency, and the occurrence of scarring is much lower than that initially thought. This indicates that effective protective measures after treatment are very important for preventing scar formation. Overall, PDL treatment for PWS shows a high level of safety and low chances of causing long-term complications.
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Affiliation(s)
- Meng Dong Shi
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
| | - Kun Yang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
| | - Shu Bo Li
- Department of Burn and Plastic Surgery, The People's Hospital Of Huaiyin Jinan, Jinan, China
| | - Qian Zhao
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran Huo
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital, Shandong University, No. 324, Jing Wu Road, Jinan, 250021, China
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Cong Fu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
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Kang J, Liu JJ, Fang YH, Lin YY, Gong W, Wang HY, Lin LH, Xiao XM. Hemoporfin-Mediated Photodynamic Therapy for Port-Wine Stains on Extremities. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00970-8. [PMID: 37405633 PMCID: PMC10366063 DOI: 10.1007/s13555-023-00970-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/16/2023] [Indexed: 07/06/2023] Open
Abstract
INTRODUCTION Pulsed dye laser (PDL) is currently considered to be the first-line treatment for port-wine stains (PWSs) on the extremities despite its less than satisfactory therapeutic efficacy. Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a vascular-targeted therapy that has rarely been used to treat PWSs on the extremities. Here, we evaluate the clinical efficacy and safety of HMME-PDT for the treatment of PWSs on the extremities. METHODS Clinical data and dermoscopic images of PWSs on the extremities were obtained from 65 patients who underwent HMME-PDT between February 2019 and December 2022. The clinical efficacy of HMME-PDT was analyzed by comparing the pre- and post-treatment images. The safety of HMME-PDT was evaluated through observation during the treatment period and post-treatment follow-up. RESULTS The efficacy rate of a single HMME-PDT session was 63.0% and that of two and three to six sessions was 86.7% and 91.3%, respectively. A positive correlation was found between therapeutic efficacy and the number of HMME-PDT sessions. The therapeutic efficacy of HMME-PDT was better on the proximal extremities than on other parts of the extremities (P = 0.038), and the efficacy of treating PWSs in each site was relatively improved with an increase of treatment time. The clinical efficacy of HMME-PDT differed across four PWS vascular patterns identified by dermoscopy (P = 0.019). However, there was no statistical difference in the therapeutic efficacy based on age, sex, type of PWS, and treatment history (P > 0.05), which may be partly attributed to the relatively small sample size or poor cooperation of infant patients. No obvious adverse reactions were observed during the follow-up period. CONCLUSIONS HMME-PDT is a very safe and effective treatment for PWSs on the extremities. Multiple HMME-PDT treatments, lesions located in proximal limbs, and PWSs with type I and IV vascular patterns under dermoscopy were associated with higher efficacy of HMME-PDT. Dermoscopy may help predict the clinical efficacy of HMME-PDT. TRIAL REGISTRATION NO 2020KJT085.
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Affiliation(s)
- Jie Kang
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China
- Department of Dermatology, Dermatology Hospital of Fuzhou, Fuzhou, 350001, China
| | - Jing-Jing Liu
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China
| | - Yu-Hong Fang
- Key Laboratory of OptoElectronic Science and Technology for Medicine of the Ministry of Education, College of Photonic and Electronic Engineering, Fujian Normal University, Fuzhou, 350007, China
| | - Yan-Yan Lin
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China
| | - Wei Gong
- Key Laboratory of OptoElectronic Science and Technology for Medicine of the Ministry of Education, College of Photonic and Electronic Engineering, Fujian Normal University, Fuzhou, 350007, China
| | - Huai-Yu Wang
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China
| | - Li-Hang Lin
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China.
| | - Xue-Min Xiao
- Department of Dermatology, The Union Hospital-Fujian Medical University, Fuzhou, 350001, China.
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Sullivan DA, da Costa AX, Del Duca E, Doll T, Grupcheva CN, Lazreg S, Liu SH, McGee SR, Murthy R, Narang P, Ng A, Nistico S, O'Dell L, Roos J, Shen J, Markoulli M. TFOS Lifestyle: Impact of cosmetics on the ocular surface. Ocul Surf 2023; 29:77-130. [PMID: 37061220 DOI: 10.1016/j.jtos.2023.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.
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Affiliation(s)
| | | | - Ester Del Duca
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | | | | | - Sihem Lazreg
- Lazreg Cornea and Ocular Surface Center, Blida, Algeria
| | - Su-Hsun Liu
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | - Alison Ng
- Centre for Ocular Research & Education, School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Steven Nistico
- Department of Dermatology, University Magna Graecia, Catanzaro, Italy
| | | | | | - Joanne Shen
- Department of Ophthalmology, Mayo Clinic in Arizona, Scottsdale, AZ, USA
| | - Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, NSW, Australia
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Yang L, Sun X, Xiang W. Double pass 595-nm dye laser is not more effective than single pass: A systematic review and meta-analysis. Skin Res Technol 2023; 29:e13237. [PMID: 36537074 PMCID: PMC9838754 DOI: 10.1111/srt.13237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/29/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Lingling Yang
- Department of Dermatology, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyu Sun
- Department of Dermatology, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenzhong Xiang
- Department of Dermatology, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China
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DeHart AN, Richter GT. Laser Treatment of Vascular Anomalies. Dermatol Clin 2022; 40:481-487. [DOI: 10.1016/j.det.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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