Clinical Application Of Skin Imaging Technology In The Evaluation Of The Efficacy Of HMME-PDT In The Treatment Of Port Wine Stains

Objective: By using VISIA,dermatoscopy,optical coherence tomography(OCT),and reflective confocal microscopy(RCM)detection techniques,the appearance and internal structural changes of port wine stains before and after HMME-PDT were described and statistically analyzed at the macro,sub micro,and micro levels,respectively.The feasibility of skin imaging detection technology in efficacy evaluation was compared with traditional digital photo evaluation methods,Further provide objective basis for clinical evaluation of treatment effectiveness.Methods: Choose between December 2021 and December 2022 in Wu Han NO.1 Hospital dermatology clinic diagnosis of PWS and 1,25 subjects HMME-PDT,a total of 40 parts,for treatment of digital photographs taken before and after 8 weeks treatment,according to the traditional method for evaluating the curative effect of 40 parts can be divided into the group,and group,the effective and ineffective group were markedly improved.VISIA-CR ?system for the facial skin lesion detection and collection of images,Image J Image analysis system is used to calculate erythema area average size and the color depth,observe the numerical change with or without statistical significance between groups,before and after treatment in the group differences are statistically significant;Using skin mirror in radiation area of the observation group vascular structure and pattern change before and after the treatment,judging the microscopic changes and clinical manifestations are consistent;Within each group can be determined through RCM deformity capillary diameter and depth of the changes before and after the treatment with or without statistical significance;By OCT scanning to obtain vascular density and depth of the treatment area,also differences in the two indicators before and after treatment with or without statistical significance.Quantitative analysis of the results need to be a mean value for the continuous determination of three time,using IBM SPSS 26.0 statistical analysis software package to statistical analysis of the results,the effect of packet statistics comparison between using single factor analysis of variance of LSD test,before and after treatment results in the group comparison using matching t test.Results:(1)After 8 weeks of hemoporfin-mediated photodynamic therapy,digital photos were taken to evaluate the efficacy.Among 40 skin lesions,2 were basal healing(5.00%),16 were significantly effective(40.00%),14 were effective(35.00%),and 8 were ineffective(20.00%);(2)The VISIA-CR ? system for 31 facial skin Image,the Image J Image analysis system after processing,the group,and group and effective group before and after treatment were markedly improved the color Image mean value difference is statistically significant(all P < 0.05),while invalid group was detected data before and after treatment with no statistical significance(P = 0.06).Comparison between groups before and after treatment between the average color depth difference was statistically significant(F = 5.44,P = 0.005),the group were markedly effective,effective,invalid group and the contrast group,the difference is statistically significant(P value were0.043,0.001,0.016),comparing two differences between the first three group were statistically significant(P < 0.05),but is invalid and effective group comparison,the result has no statistical significance(P = 0.27).(3)The group,the group were markedly effective,effective,invalid group before and after treatment the skin microscopic vascular structure and pattern change and clinical improvement are almost the same,some cases microscopically improve significantly greater than the naked eye,skin and microscopically observed vascular density change impossible to quantify,greatly influenced by other pigment and structure change;(4)Using RCM scanning,according to the results of comparison between groups before and after treatment,on average,blood vessel diameter difference is statistically significant(F= 9.47,P = 0.004),LSD two comparison between groups,group with effective group were markedly improved(P = 0.006),and invalid group(P = 0.006)were markedly improved,effective and ineffective group differences were statistically significant(P =0.012).Comparison group,the group,and group,the effective group were markedly improved vascular average diameter changes before and after the treatment was statistically significant(P < 0.05),there was no statistically significant difference is invalid group(t = 4.97,P = 0.42).Comparison between groups,the average depth of vascular differences were statistically significant(F = 9.474,P = 0.004),LSD between two groups,group with effective group were markedly improved(P = 0.023),and invalid group(P = 0.009)were markedly improved,effective and ineffective group differences were statistically significant(P = 0.042),the more base group of 2 cases of the small sample size does not do statistical analysis.Comparison group,the group,and group,the effective group were markedly improved vascular average diameter changes before and after the treatment was statistically significant(P < 0.05),there was no statistically significant difference is invalid group(t = 5.83,P = 0.85).(5)Using OCT skin treatment site of vascular density,depth data,group comparison,in addition to the invalid group,OCT were observed before and after treatment is calculated each group average vascular density and average blood vessels depth difference have statistical significance(P < 0.05).Comparison between groups,the average vascular density differences were statistically significant(F = 14.60,P = 0.022),LSD two comparison between groups,group with effective group were markedly improved(P = 0.034),and invalid group(P = 0.014)were markedly improved,effective and ineffective group differences were statistically significant(P = 0.043),the more base group of 2 cases of the small sample size cannot be analyzed.Comparison between groups,the average depth of vascular differences are statistically significant(F = 8.67,P = 0.035),LSD two comparison between groups,group with effective group were markedly improved(P = 0.017),and invalid group(P = 0.025)were markedly improved,effective and ineffective group differences were statistically significant(P = 0.038),the more base group of 2 cases of the small sample size cannot be analyzed.Conclusion:1.Compared with traditional methods,the use of skin imaging detection techniques such as VISIA,RCM,OCT,etc.in combination can obtain data on the average color depth and area of skin lesions,the average diameter,depth,and density changes of deformed blood vessels before and after the treatment of port-wine stain with hemoporfin-mediated photodynamic therapy,making the results more refined and feasible in efficacy evaluation.2.The combined application of VISIA,dermatoscopy,RCM,and OCT to evaluate the efficacy of hemoporfin-mediated photodynamic therapy in the treatment of port-wine stain can be observed from macro,sub micro,and micro levels,complementing each other and providing more comprehensive and reliable evidence.3.Dermatoscopy has significant value in qualitative prediction of therapeutic effects.However,due to the inability to quantitatively measure changes in vascular density,as well as the diverse vascular patterns and dynamic changes in background color in skin lesions,its application value in photodynamic efficacy evaluation is limited.