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Jantarakolica T, Wanitphakdeedecha R, Yan C, Yogya Y, Manuskiatti W, Sudhipongpracha T. Dermatology Life Quality Index in Thai Patients with Facial Port-Wine Stains. Dermatol Ther (Heidelb) 2023; 13:2375-2386. [PMID: 37710079 PMCID: PMC10539252 DOI: 10.1007/s13555-023-01011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Port-wine stains (PWS) are congenital capillary abnormalities caused by immature, venule-like vasculature that progressively dilates due to poor endothelial cell differentiation. PWS affects between 0.3% and 0.9% of newborns, with 90% of cases occurring on the face. Individuals with facial PWS and their parents had a significant negative impairment on their quality of life (QoL) and also suffered from psychological disabilities. METHODS This was a cross-sectional questionnaire-based survey study in Thailand from July 2021 to April 2022. The questionnaires included demographic data, subjective evaluation (SE), and the Dermatology Life Quality Index (DLQI). The questionnaire was performed with a full scale and adjusted scale of validity and reliability test of DLQI using factor analysis and Cronbach's alpha. The study outcome was a subjective evaluation and DLQI in patients who received pulsed dye laser (PDL) treatment. RESULTS Of the 54 patients, 35.2% (19) are male, and 64.8% (35) are female. Regarding age groups, 64.8% (35) are below 5 years old, and 35.2% (19) are older than 5 years. SE results showed that males evaluated an improvement of the facial PWS lesion significantly better than females (P < 0.05). The older age group graded the percentage of improvement better than the younger age group (P < 0.01). The result of the DLQI showed no difference in DLQI between gender. Older age result resulted in a significantly different DLQI compared with younger age (P < 0.01). Parent-reported DLQI improvement was less than self-reported DLQI improvement in patients with PWS treated with PDL (P < 0.05). Concerning the instrument of the study, the validity and reliability analysis of the DLQI questionnaire using factor analysis and Cronbach's alpha have been performed. The adjusted scale with the 5-item DLQI questionnaire is more appropriate in terms validity and reliability. CONCLUSION This study demonstrates that facial PWS reduces the QoL as measured by DLQI. We discovered that the QoL of patients and parents with PWS was significantly impaired. The main influencing factors were older age, the improved perception between gender, and PDL treatments. In addition, we found only five questions that are reliable for PWS. The adjusted five-item DLQI questionnaires are more appropriate regarding validity and reliability. TRIAL REGISTRATION NUMBER TCTR20230210001, COA no. si 1059/2020.
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Affiliation(s)
| | - Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok, 10700, Thailand.
- College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand.
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok, 10700, Thailand
| | - Yuri Yogya
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok, 10700, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-Nok Road, Bangkok, 10700, Thailand
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Zhao Q, Liu L, Li X, Yang L, Jiang X. An Unexpected Finding: Treatment History Associated with the Quality of Life in Chinese Patients with Port-Wine Stains. Clin Cosmet Investig Dermatol 2023; 16:1969-1975. [PMID: 37533495 PMCID: PMC10391529 DOI: 10.2147/ccid.s421296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
Background Port-wine stains (PWS) are predominantly located on the face and neck. Hence, PWS affect not only aesthetic appearance but may also cause psychological distress. However, very few studies have researched on the quality of life (QoL) in Chinese patients with PWS. Aim To evaluate QoL in patients with PWS. Methods and Materials Skindex-29 and Dermatology Life Quality Index (DLQI) were used to investigate the QoL of the patients with PWS and healthy controls. Results In total, 198 adults with PWS and 200 healthy controls were included. The scores of symptomatic, emotional and functional dimensions of Skindex-29 in the observational group were significantly higher as compared with the control group (P<0.05). Female gender, lesion location and the treatment history (such as pulsed dye laser or photodynamic therapy) had a negative impact on the scores (emotional and functional dimensions) of the patients with PWS. The median DLQI score was 3 points in the observational group and 0 points in the control group (P<0.05), and QoL of patients who had a history of previous treatments was diminished. Conclusion The QoL of patients with PWS is impaired. Patients' QoL is negatively influenced by female gender, lesion location and treatment history. The Skindex-29 scale seems to be more applicable to the study of QoL of patients with PWS.
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Affiliation(s)
- Qian Zhao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Department of Medical Cosmetology, Chengdu Second People’s Hospital, Chengdu, Sichuan, 610021, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Lian Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xiaoxue Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Lihua Yang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology (CIII), Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China
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Langbroek GB, Felsbourg J, Wolkerstorfer A, Horbach SE, Kooger LS, van Dieren S, van Not OJ, Pieter van Not H, Souisa R, Ubbink DT, van der Horst CM. Patient-Reported Outcomes of Medical Tattooing for Capillary Malformations. Dermatology 2023; 239:768-781. [PMID: 37442102 PMCID: PMC10614224 DOI: 10.1159/000530609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/20/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Patients with capillary malformations (CMs) may undergo medical tattooing (MT) as an alternative to laser therapy. But little is known about treatment results and impact from the patients' perspective. OBJECTIVES In this cross-sectional digital survey study, we evaluated the patient-reported outcomes of MT for CMs. METHODS MT practices were identified via the Dutch Association of Skin Therapists and Google. These practices invited all their CM patients who had undergone MT between January 2011 and September 2021 to participate. Baseline and treatment characteristics, tattooing effectiveness, patient satisfaction with treatment outcomes, and complications were evaluated using a custom-made online survey. Quality of life was assessed with the Dermatology Life Quality Index (DLQI) questionnaire. Factors associated with treatment effectiveness and patient satisfaction were identified via bivariate analysis and ordinal logistic regression analysis. RESULTS Most of the 89 respondents were female (69%). Almost all CMs were located on the face (90%) and mainly (dark) red (74%). Nearly all patients had undergone laser therapy (91%). Median number of tattooing sessions was 5 (IQR: 4.0-8.0). Thirty-seven percent of the patients perceived >75% color reduction. Younger patients were more likely to obtain lower treatment effectiveness (OR 0.44, 95% CI: 0.20-0.97). Most patients (83%) were satisfied with treatment results. Patients with lighter (OR 0.30, 95% CI: 0.13-0.72), non-facial (OR 0.15, 95% CI: 0.03-0.89), and hypertrophic CMs (OR 0.30, 95% CI: 0.11-0.82) were less likely to be satisfied with treatment outcomes. Patients with lighter skin types were more satisfied (OR 2.89, 95% CI: 1.23-6.80). Complications included transient pain (23%), bleeding (3.4%), hypertrophic scarring (1.1%), hypopigmentation (1.1%), and a halo around the tattoo (1.1%). CONCLUSION MT seems a valid alternative treatment in addition to laser therapy for CMs, with mild complications. Most patients are (very) satisfied with treatment results, while color reduction is incomplete. Hence, it seems appropriate to decide together with patients whether or not to use MT as primary treatment or secondary to laser therapy.
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Affiliation(s)
- Ginger Beau Langbroek
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Julia Felsbourg
- Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Dermatology, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Immunity and Infections, University of Amsterdam, Amsterdam, The Netherlands
| | - Sophie E.R. Horbach
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Susan van Dieren
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Olivier J. van Not
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
- Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans Pieter van Not
- Plastic Reconstructive and Hand Surgery, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Rinus Souisa
- Medical Tattoo Innovations, Goes, The Netherlands
| | - Dirk T. Ubbink
- Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Chantal M.A.M. van der Horst
- Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
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Psychosocial implications of rare genetic skin diseases affecting appearance on daily life experiences, emotional state, self-perception and quality of life in adults: a systematic review. Orphanet J Rare Dis 2023; 18:39. [PMID: 36823650 PMCID: PMC9951542 DOI: 10.1186/s13023-023-02629-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Since the beginning of human genetic research, there are very few publications sharing insights of the negative impact of rare genetic skin diseases (RGSD) on patients' experiences. This systematic review assessed the psychosocial implications of these conditions in terms of daily life experiences, emotional state, self-perception, and Quality of Life (QoL). METHODOLOGY A systematic review was carried out on albinism, neurofibromatosis type 1 (NF1), birthmarks and inherited ichthyosis. The PubMed, Scopus, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection, and SOCindex databases were queried. Inclusion criteria were adult patients with one of these RGSDs. Simple descriptive statistics and qualitative content analysis were conducted to summarize the main results reported by the authors. RESULTS Of the 9987 articles retrieved, 48 articles were included: albinism (16), NF1 (16), inherited ichthyosis (10), birthmarks (6). The majority of the studies on albinism were conducted in Africa. Twenty-seven studies quantitatively assessed diverse psychological parameters: 13 showed a significant impact of the disease on QoL, five on emotional state, two on self-representation and two others on psychiatric comorbidities. Disease severity and visibility were good predictors of QoL (except for albinism). Body image and appearance concerns were also associated with QoL and emotional state. The 19 qualitative studies highlighted recurring themes across each of these diseases: discrimination and stigma during childhood and adolescence, discomfort in social interactions, guilt of transmission, the importance of social support from family and friends, altered daily life functioning, altered romantic and sex life, limited academic and professional aspirations, lack of interest and support from the medical field, and the unpredictability of the evolution of the disease. The only two mixed-method studies in this review were unable to contribute to any inferential analyses but could corroborate some of the qualitative findings. CONCLUSION These results showed that RGSDs have a significant impact on different aspects of patients' lives. This review has demonstrated that there is a real need for support systems for patients with these diseases. Such systems should be developed to provide them with necessary information and to guide them through an appropriate care pathway.
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Robert J, Marchand A, Mazereeuw-Hautier J, Boccara O, Martin L, Chiaverini C, Beneton N, Vabres P, Balguerie X, Plantin P, Bessis D, Barbarot S, Dadban A, Droitcourt C, Samimi M, Morel B, Caille A, Maruani A, Leducq S. Quality of life of children with capillary malformations of the lower limbs: Evolution and associated factors. Data from the French national paediatric cohort, CONAPE. Ann Dermatol Venereol 2022; 149:271-275. [PMID: 35810006 DOI: 10.1016/j.annder.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 01/19/2023]
Affiliation(s)
- J Robert
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France
| | - A Marchand
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France
| | - J Mazereeuw-Hautier
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), Hospital Larrey, University Hospital Center of Toulouse, 31059 Toulouse Cedex 9, France
| | - O Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC), France Université Paris, Paris-centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, AP-HP, 75015 Paris, France
| | - L Martin
- Department of Dermatology, University Hospital Center of Angers, 49000 Angers, France
| | - C Chiaverini
- Department of Dermatology, University Hospital Center of Nice, 06000 Nice, France
| | - N Beneton
- Department of Dermatology, Hospital Center of le Mans, 72000 Le Mans, France
| | - P Vabres
- Department of Dermatology, University Hospital Center of Dijon, Reference center for genodermatoses and rare skin diseases (MAGEC), 21000 Dijon, France
| | - X Balguerie
- Department of Dermatology, University Hospital Center of Rouen, 76000 Rouen, France
| | - P Plantin
- Department of Dermatology, Hospital Center of Quimper, 29000 Quimper, France
| | - D Bessis
- Department of Dermatology, University Hospital Center of Montpellier, 34000 Montpellier, France
| | - S Barbarot
- Department of Dermatology, University Hospital Center of Nantes, 44000 Nantes, France
| | - A Dadban
- Department of Dermatology, University Hospital Center of Amiens, 80000 Amiens, France
| | - C Droitcourt
- Department of Dermatology, University Hospital Center of Rennes, 35000 Rennes, France
| | - M Samimi
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France
| | - B Morel
- CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Department of Pediatric Radiology, 37000 Tours, France
| | - A Caille
- CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - A Maruani
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; CHRU Tours, Clinical Investigation Center-Inserm 1415, 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France
| | - S Leducq
- University Hospital Center of Tours (CHRU), Department of Dermatology, Unit of Pediatric Dermatology, 37044 Tours Cedex 9, France; CHRU Tours, Reference center for genodermatoses and rare skin diseases - vascular anomalies (MAGEC), 37000 Tours, France; Universities of Tours and Nantes, SPHERE-INSERM 1246, 37000 Tours, France.
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NK and cells with NK-like activities in cancer immunotherapy-clinical perspectives. Med Oncol 2022; 39:131. [PMID: 35716327 DOI: 10.1007/s12032-022-01735-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/13/2022] [Indexed: 01/10/2023]
Abstract
Natural killer (NK) cells are lymphoid cells of innate immunity that take important roles in immune surveillance. NK cells are considered as a bridge between innate and adaptive immunity, and their infiltration into tumor area is related positively with prolonged patient survival. They are defined as CD16+ CD56+ CD3- cells in clinic. NK cells promote cytolytic effects on target cells and induce their apoptosis. Loss of NK cell cytotoxic activity and reduction in the number of activating receptors are the current issues for application of such cells in cellular immunotherapy, which resulted in the diminished long-term effects. The focus of this review is to discuss about the activity of NK cells and cells with NK-like activity including natural killer T (NKT), cytokine-induced killer (CIK) and lymphokine-activated killer (LAK) cells in immunotherapy of human solid cancers.
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Achavanuntakul P, Manuskiatti W, Wanitphakdeedecha R, Jantarakolica T. Early Treatment Initiation Improves Outcomes in Nevus of Ota: A 10-Year Retrospective Study. Am J Clin Dermatol 2022; 23:105-114. [PMID: 34693508 DOI: 10.1007/s40257-021-00637-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nevus of Ota is a psychologically burdensome facial pigmentation birthmark common in Asian populations. Laser therapy is currently the first-line treatment, but no guidelines on when to initiate treatment have yet been established. OBJECTIVES Our objective was to determine the correlation between treatment efficacy and safety, risk of recurrence, and age of treatment initiation in patients receiving laser therapy for nevus of Ota. METHODS We conducted a 10-year (2008-2018) retrospective cohort study of all patients who completed a minimum of five laser treatments at Siriraj Skin Laser Center, Mahidol University, Bangkok, Thailand. RESULTS A total of 84 patients (aged 4 months-50 years) with nevus of Ota lesions were enrolled in the study. All patients were treated with a 1064-nm Q-switched Nd:YAG or a 755-nm or 1064-nm picosecond-domain laser (or a combination thereof). Our analysis identified that initiation of laser therapy before the age of 5 years was a significant factor in reducing the number of sessions necessary to achieve aesthetic improvement (P < 0.01; 95% confidence interval [CI] 1.06-3.21). In total, 18 patients (21.4%) initiating treatment before the age of 5 years required an average of 2, 4, and 7 treatment sessions to achieve > 25, 50, and 75% of pigment lightening, respectively, whereas 66 patients (78.6%) initiating treatment after the age of 5 years required an average of 3, 7, and 11 sessions to achieve comparable clearance. The risk of postinflammatory hyperpigmentation was significantly lower in patients starting treatment before the age of 5 years (P < 0.01; 95% CI - 43.76 to - 11.94). Recurrences were not observed in patients achieving > 95% clearance. CONCLUSIONS In our patient cohort, initiation of laser treatment for nevus of Ota before the age of 5 years significantly improved therapeutic outcomes and reduced the risk of adverse events and recurrence. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov PRS number: NCT04481178.
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Affiliation(s)
- Petchlada Achavanuntakul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand.
| | - Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand
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Chun-Hua T, Li-Qiang G, Hua W, Jian Z, Si-Li N, Li L, Yi W, Can L, Xiao-Yan L, Guang-Hui W. Efficacy and safety of hemoporfin photodynamic therapy for port-wine stains in paediatric patients: A retrospective study of 439 cases at a single centre. Photodiagnosis Photodyn Ther 2021; 36:102568. [PMID: 34614424 DOI: 10.1016/j.pdpdt.2021.102568] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although hemoporfin photodynamic therapy is a promising treatment approach for port-wine stains, its efficacy in children has not been sufficiently assessed. We aimed to evaluate the efficacy and safety of this approach in a paediatric population. METHODS We retrospectively analysed the medical records of 439 children with port-wine stains receiving hemoporfin photodynamic therapy at our institution from July 2017 to January 2020. They received intravenous hemoporfin (hematoporphyrin monomethyl ether, 5 mg/kg), followed by lesion irradiation with a 532-nm green LED light for 20-25 min. The stains' blanching degree and occurrence of adverse events were registered. RESULTS Overall, 95.2% of patients showed an 'effective response' (>20% fading) and 74.3% showed almost-complete resolution and great improvement (≥60% fading). Red and pink lesions showed better response than purple lesions (P < 0.05). Neck and facial lesions showed better response than the trunk and extremity lesions (P < 0.05). The response of the patients to the PDT showed a cumulative effect of the treatment session. No photosensitivity or systemic adverse reactions were observed. Transient local adverse effects included swelling, purpura, crusts, and pigmentation, which resolved without treatment. Only 2% of children had permanent scars, likely related to scratching crusts. CONCLUSIONS Hemoporfin photodynamic therapy was well tolerated and effective in paediatric Chinese patients with port-wine stains. It could be recommended as the first choice, over pulsed-dye laser therapy, for treating port-wine stains, particularly for large lesions. This should be evaluated in direct clinical trials.
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Affiliation(s)
- Tan Chun-Hua
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Gan Li-Qiang
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Wang Hua
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhang Jian
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Ni Si-Li
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Liu Li
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Wan Yi
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Li Can
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Luo Xiao-Yan
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Wei Guang-Hui
- Department of Dermatology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders; Chongqing Key Laboratory of Pediatrics; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering; Children's Hospital of Chongqing Medical University, Chongqing, PR China.
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Rencz F, Szabó Á, Brodszky V. Questionnaire Modifications and Alternative Scoring Methods of the Dermatology Life Quality Index: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1158-1171. [PMID: 34372982 DOI: 10.1016/j.jval.2021.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/02/2021] [Accepted: 02/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Dermatology Life Quality index (DLQI) is the most widely used health-related quality of life questionnaire in dermatology. Little is known about existing questionnaire or scoring modifications of the DLQI. We aimed to systematically review, identify, and categorize all modified questionnaire versions and scoring methods of the DLQI. METHODS We performed a systematic literature search in PubMed, Web of Science, CINAHL, and PsychINFO. Methodologic quality and evidence of psychometric properties were assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) and Terwee checklists. RESULTS The included 81 articles reported on 77 studies using 59 DLQI modifications. Modifications were used for a combined sample of 25 509 patients with 47 different diagnoses and symptoms from 28 countries. The most frequently studied diseases were psoriasis, hirsutism, acne, alopecia, and bromhidrosis. The modifications were categorized into the following nonmutually exclusive groups: bolt-ons or bolt-offs (48%), disease, symptom, and body part specifications (42%), changes in existing items (34%), scoring modifications (27%), recall period changes (19%), response scale modifications (15%), and illustrations (3%). The evidence concerning the quality of measurement properties was heterogeneous: 4 of 13 studies were rated positive on internal consistency, 1 of 3 on reliability, 3 of 5 on content validity, 9 of 22 on construct validity, 6 of 6 on criterion validity, and 1 of 1 on responsiveness. CONCLUSION An exceptionally large number of DLQI modifications have been used that may indicate an unmet need for adequate health-related quality of life instruments in dermatology. The psychometric overview of most questionnaire modifications is currently incomplete, and additional efforts are needed for proper validation.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Budapest, Hungary.
| | - Ákos Szabó
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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10
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Wanitphakdeedecha R, Ng JNC, Yan C, Manuskiatti W, Sudhipongpracha T, Jantarakolica T. Quality of Life and Psychological Effects of Port-Wine Stain: A Review of Literature. Clin Cosmet Investig Dermatol 2021; 14:681-690. [PMID: 34188511 PMCID: PMC8235992 DOI: 10.2147/ccid.s315804] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/12/2021] [Indexed: 12/14/2022]
Abstract
Introduction Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can cause a physiological or psychological burden to the patients. At present, most of the studies done on PWS are focused on the treatment rather than the quality of life and psychological effects of the disease. Material and Methods A comprehensive literature search was done in MEDLINE using PubMed database, Embase®, and Cochrane. All observational studies were included in this review. Results A total of 17 relevant articles with 2,135 PWS patients were included in this review. There were 36 measurement tools used to assess the quality of life and the psychological effects among PWS patients. The results showed that patients with facial PWS had a significant negative effect on their quality of life and had also suffered from psychological disabilities. The PWS lesion tends to worsen with age and may cause further adaptation problems towards the social environment, especially in children. Conclusion Early treatment, psychological assistance, and patient support are the key management in improving the quality of life of patients with PWS. Quality of life must be regularly assessed together with the improvement of treatment.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand
| | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Woraphong Manuskiatti
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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11
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Wanitphakdeedecha R, Sudhipongpracha T, Ng JNC, Yan C, Jantarakolica T. Self-stigma and psychosocial burden of patients with port-wine stain: A systematic review and meta-analysis. J Cosmet Dermatol 2021; 20:2203-2210. [PMID: 33949094 DOI: 10.1111/jocd.14199] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Port-wine stain (PWS) is a congenital malformation that does not resolve spontaneously and can lead to social and self-stigma. However, little is known about how PWS affects the patients' quality of life (QoL) and psychosocial well-being. In this article, we examine the existing empirical evidence on self-stigma caused by PWS. METHODS A systematic review was done using MEDLINE, PubMed, Embase, and Cochrane databases on January 15, 2021 to retrieve all case reports, cohort studies, and clinical trials written in English. The keywords used in this literature search included port-wine stain, quality of life, self-stigma, and social stigma. RESULTS From the 74 initial records, eight articles were quantitative studies that assessed the QoL and self-stigma experienced by PWS patients. With regard to perceived stigma or the patients' understanding of how others think and act toward them, we found that the parents of children with facial PWS tend to have more perceived stigma than the children. For anticipated stigma or expectations of future stigma, young patients with PWS have less or no concern about their skin conditions. In terms of enacted stigma or experiences with discriminatory acts, there were significant differences in the QoL score between patients with facial PWS and those with non-facial PWS. CONCLUSION This study suggests that self-stigma caused by PWS affects young patients and their parents. The parents in particular tend to suffer more than their children from perceived and anticipated stigma. Psychological support and early treatment can improve the livelihoods of young patients and their parents.
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Affiliation(s)
- Rungsima Wanitphakdeedecha
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,College of Interdisciplinary Studies, Thammasat University, Bangkok, Thailand
| | | | - Janice Natasha C Ng
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chadakan Yan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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12
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van Raath MI, Chohan S, Wolkerstorfer A, van der Horst CMAM, Limpens J, Huang X, Ding B, Storm G, van der Hulst RRWJ, Heger M. Treatment Outcome Measurement Instruments for Port Wine Stains: A Systematic Review of Their Measurement Properties. Dermatology 2020; 237:416-432. [PMID: 33271556 PMCID: PMC8117375 DOI: 10.1159/000511438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/03/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A plethora of outcome measurement instruments (OMIs) are being used in port wine stain (PWS) studies. It is currently unclear how valid, responsive, and reliable these are. OBJECTIVES The aim of this systematic review was to appraise the content validity and other measurement properties of OMIs for PWS treatment to identify the most appropriate instruments and future research priorities. METHODS This study was performed using the updated Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology and adhered to PRISMA guidelines. Comprehensive searches in Medline and Embase were performed. Studies in which an OMI for PWS patients was developed or its measurement properties were evaluated were included. Two investigators independently extracted data and assessed the quality of included studies and instruments to perform qualitative synthesis of the evidence. RESULTS In total, 1,034 articles were screened, and 77 full-text articles were reviewed. A total of 8 studies were included that reported on 6 physician-reported OMIs of clinical improvement and 6 parent- or patient-reported OMIs of life impact, of which 3 for health-related quality of life and 1 for perceived stigmatization. Overall, the quality of OMI development was inadequate (63%) or doubtful (37%). Each instrument has undergone a very limited evaluation in PWS patients. No content validity studies were performed. The quality of evidence for content validity was very low (78%), low (15%), or moderate (7%), with sufficient comprehensibility, mostly sufficient comprehensiveness, and mixed relevance. No studies on responsiveness, minimal important change, and cross-cultural validity were retrieved. There was moderate- to very low-quality evidence for sufficient inter-rater reliability for some clinical PWS OMIs. Internal consistency and measurement error were indeterminate in all studies. CONCLUSIONS There was insufficient evidence to properly guide outcome selection. Additional assessment of the measurement properties of OMIs is needed, preferentially guided by a core domain set tailored to PWS.
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Affiliation(s)
- M Ingmar van Raath
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, China
| | - Sandeep Chohan
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Chantal M A M van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Medical Library, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Xuan Huang
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, China
| | - Baoyue Ding
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, China
| | - Gert Storm
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - René R W J van der Hulst
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Michal Heger
- Department of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands, E.
- Department of Pharmaceutics, Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, College of Medicine, Jiaxing University, Jiaxing, China, E.
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13
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Huang Y, Yang J, Li Z, Zhang L, Sun L, Bi M, Wang L. Dermoscopic features of port-wine stains: A study of 264 cases. Australas J Dermatol 2020; 62:e201-e206. [PMID: 32955124 DOI: 10.1111/ajd.13470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/19/2020] [Accepted: 08/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Port-wine stains (PWS) occur in 0.3-0.5% of the population. However, the dermoscopic features of PWS have not been systematically studied. METHODS Dermoscopic images of 264 cases with PWS were retrospectively analysed. RESULTS Linear vessels were the most frequent dermoscopic features of PWS (42.0%). Other dermoscopic features were reticular vessels (28.0%), sausage-like vessels (13.6%), dots or globules vessels (9.1%) and mixed vessels (7.2%). Nonvascular morphology comprised white circles (13.6%) and whitish veil (38.3%). Sausage-like vessels and whitish veil were mainly present in the thickened type and in those with PWS aged ≥18 years; mixed vessels were mainly present in purple type of PWS. Dermoscopic features showed no significant difference between lesions located on different facial areas (V1, V2 and V3). Dots or globular vessels were more common in non-facial lesions (P < 0.0001). White circles were only found in the facial lesions, and the frequency of white circles and whitish veil was higher in the treated group than in the untreated group (P = 0.004 and P = 0.04, respectively). The frequency of white circles was significantly higher in the prior treated group than in the untreated group (P < 0.0001). CONCLUSION There are various of dermoscopic features of PWS. The dermoscopic features of patients with PWS may correlate with age, subtype, location, prior treatment history and pulsed dye laser (PDL) resistance.
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Affiliation(s)
- Yuanbo Huang
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Jun Yang
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Zhongming Li
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Lichao Zhang
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Li Sun
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Mingye Bi
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
| | - Lei Wang
- Department of Dermatology and Venereology, Nanjing Medical University Affiliated Wuxi People's Hospital, Wuxi, China
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14
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Ma G, Han Y, Ying H, Zhang X, Yu W, Zhu J, Cen Q, Chen H, Jin Y, Lin X. Comparison of Two Generation Photosensitizers of PsD-007 and Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Treatment of Port-Wine Stain: A Retrospective Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 37:376-380. [PMID: 31188091 DOI: 10.1089/photob.2018.4593] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To compare the efficacy and safety of the two generation photosensitizers, PsD-007 and hematoporphyrin monomethyl ether (HMME), for photodynamic therapy (PDT) of port-wine stain (PWS). Background: Vascular-targeted PDT has shown potentially beneficial results in treating PWS; however, the efficacy and safety of various photosensitizers have not been fully investigated. Materials and methods: We retrospectively analyzed 38 patients with PWS, who were treated with one session of PsD-007-mediated (n = 21) or HMME-mediated (n = 17) PDT. Clinical efficacy was assessed by a chromameter and visual assessment of color blanching of the PWS lesion. Adverse events were evaluated. Results: Neither visual nor chromameter optical evaluations showed significant differences between the PsD-007 and HMME groups (p = 0.337 and p = 0.191, respectively). The total response rate was 76.2% (n = 16) in the PsD-007 group and 88.2% (n = 15) in the HMME group. Good or excellent clearance was achieved in 42.9% patients in the PsD-007 group and 29.4% patients in the HMME group. The average ΔE (color expressed change or improvement) and mean blanching rate measured optically were higher in the PsD-007 group than in the HMME group without statistical differences (8.51 vs. 7.39, p = 0.649; 0.37 vs. 0.29, p = 0.191). Incidences of swelling, pruritus, scab formation, and other adverse reactions were similar for the two groups. There were no blisters, scarring, or hypopigmentation in either group. Conclusions: Both PsD-007- and HMME-mediated PDTs are effective and safe for treatment of PWS. However, HMME has a shorter photosensitivity period than does PsD-007, which might be more recommended.
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Affiliation(s)
- Gang Ma
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,2 Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Han
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,2 Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanru Ying
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaolin Zhang
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenxin Yu
- 2 Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiafang Zhu
- 2 Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingqing Cen
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Chen
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunbo Jin
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoxi Lin
- 1 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,2 Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Surgical Treatment for Facial Port Wine Stain by Prefabricated Expanded Cervical Flap Carried by Superficial Temporal Artery. J Craniofac Surg 2019; 30:2124-2127. [PMID: 31503119 DOI: 10.1097/scs.0000000000005612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Port wine stain (PWS) is a congenital benign vascular malformation. Laser treatment is the main therapy for PWS. But some patients are not sensitive to it, and failed laser treatment will leave scars on face. Hence in this study, the authors used prefabricated flap carried by superficial temporal artery to treat PWS. METHODS Nine patients diagnosed with large-scaled PWS (occupying more than half of the cheek) from January 2008 to December 2017 were selected in the study. One of them did not finish the treatment. Eight patients completed all scheduled treatments. In the first stage, superficial temporal vessels were transferred to the donor site and then an expander was implanted. About 80 to 150 days later, PWS was removed and the prefabricated flap was used to repair the wound. All the 8 patients were followed-up for 10 months to 36 months. RESULTS Prefabricated flap survived well. All patients are satisfied with the appearance. The color and texture of prefabricated flap is similar to the surroundings. CONCLUSION The combination of prefabricated flap and skin soft tissue expander not only extends the scale of flap but also enhances the efficacy of surgical treatment. It is a good candidate to treat PWS.
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Severe Port Wine Stain with Significant Nodules and Alveolar Bone Invasion Leading to Restricted Mouth Opening. INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2019. [DOI: 10.1097/jd9.0000000000000031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Mei Y, Xiao X, Fan L, Liu Q, Zheng M, Hamblin MR, Ni B, Yin R. In vitro photodynamic therapy of endothelial cells using hematoporphyrin monomethyl ether (Hemoporfin): Relevance to treatment of port wine stains. Photodiagnosis Photodyn Ther 2019; 27:268-275. [PMID: 31185325 DOI: 10.1016/j.pdpdt.2019.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/01/2019] [Accepted: 06/07/2019] [Indexed: 12/16/2022]
Abstract
Hemoporfin (hematoporphyrin monomethyl ether, HMME) is a relatively new photosensitizer that has achieved success in mediating photodynamic therapy (PDT) of port wine stains in China. However, the exact mechanism of Hemoporfin PDT on endothelial cell proliferation and apoptosis is unclear. The present study investigated the mechanism of action of HMME-PDT on endothelial cells in vitro. Human umbilical vein endothelial cells (HUVECs) were cultured in vitro. HMME-PDT treated the cells and detected the phototoxicity by cell counting kit-8 (CCK-8) assay, apoptosis by Flow cytometry assay and quantification of the secreted VEGF-A levels using ELISA and different proteins expression by quantitative real-time PCR and Western blotting. Phototoxicity was caused in an HMME and light dose-dependent manner. Apoptosis was induced as shown by Annexin-V/propidium iodide staining and morphological changes. The Bax/Bcl-2 ratio was increased as shown by Western blot for protein and RT-qPCR for mRNA. VEGF-A expression was reduced and signaling molecules in the Akt/mTOR pathway were inhibited as shown by ELISA and immunofluorescence. Hemoporfin (hematoporphyrin monomethyl ether, HMME) has achieved success in mediating photodynamic therapy (PDT) of port wine stains. The clinical success of HMME-PDT with low recurrence rates can be explained by inhibition of endothelial cell proliferation through VEGF/Akt /mTOR pathway.
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Affiliation(s)
- Yingjuan Mei
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Xiangling Xiao
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China; State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, 400715, China
| | - Lili Fan
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Qichao Liu
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China; State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, 400715, China
| | - Mengxue Zheng
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA
| | - Bing Ni
- Department of Pathophysiology, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China.
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