Clinical Research On Hemoporfin Photodynamic Therapy For Port Wine Stains And Analysis Of The Family Quality Of Life

BackgroundPort wine stains(PWS)is a congenital capillary malformation that can occur at birth and usually does not naturally subside,gradually worsening with age.Sometimes,PWS can also cause complications such as glaucoma,arteriovenous malformations,and limb arteriovenous fistulas,which can damage the patient’s own physical and mental health to varying degrees.At present,Pulsed dye laser(PDL)is the golden standard for the treatment of PWS,but it cannot achieve a complete cure in most cases,and some patients also develop PDL-resistance due to multiple treatments.In recent years,hematoporphyrin monomethyl ether photodynamic therapy(HMMEPDT)has been applied as a safer and more effective alternative therapy for the treatment of P W S.ObjectiveTo analyze the related factors to the efficacy of hemoporfin photodynamic on port wine stains,and to provide a degree of reference for clinical practice.To evaluate the impact of PWS on the quality of life in families of children receiving HMMEPDT treatment.Part one:Analysis of factors related to the efficacy of HMMEPDT in the treatment of PWSMethodsThe medical records of 276 PWS patients who visited the dermatological department of Qilu Hospital of Shandong University from March 2019 to December 2022 and received 1-6 HMME-PDT were collected,of which 122 patients underwent dermatoscopy before treatment.Analyze the influence of related factors(gender,age,Fitzpatrick skin type,location,type,area,treatment times,previous treatment history,and dermoscopic vascular types)on the efficacy of patients.Using SPSS 26.0 software,Mann Whitney test and Kruskal Wallis test were used for univariate analysis,correlation analysis was performed using the Spearman test,and ordered multiclass logistic regression analysis was used for multivariate analysis.Results1.Efficacy:40 cases of basic recovery(14.49%),95 cases of marked effect(34.42%),improvement in 83 cases(30.07%),58 cases of ineffectiveness(21.02%).The total number of effective cases(basic recovery+marked effect+improvement)were 218 cases(78.99%).2.Related factors:Univariate analyses indicated statistically significant differences in the age,Fitzpatrick skin type,location,type,area,treatment times,and dermoscopic vascular types on efficacy(P<0.05),while there was no statistically significant differences in gender and previous treatment history on efficacy(P>0.05).Correlation analysis showed that age,Fitzpatrick skin type,type,area,and treatment times were all correlated with efficacy.Multifactorial logistic analysis showed that Fitzpatrick skin type Ⅳ,lesions situated in the trunk and extremities of the body,Thickened type were adverse factors affecting the efficacy.Conclusions1.HMME-PDT is a safe and effective treatment for PWS,with a total effective rate of 78.99%.The efficacy was related to Fitzpatrick skin type,location,type,area,and treatment times,but was not related to gender or previous treatment history.2.There are a variety of vascular types under the dermoscopy of PWS,and determining the vascular types of PWS by dermoscopy is helpful in predicting the efficacy of HMME-PDT.Part two:Analysis of the family quality of life of children with PWSMethodsA total of 51 children aged 3-16 years old and their parents were evaluated for the quality of life using the Chinese version of the Children’s Dermatology Life Quality Index(CDLQI)and the Family Dermatology Life Quality Index(FDLQI).All the patients were admitted to the dermatological department of Qilu Hospital of Shandong University from December 2021 to February 2023 and received HMMEPDT treatment.SPSS 26.0 software,Mann-Whitney test,Kruskal-Wallis test,paired t-test and Spearman’s test was used for the statistical analyses.Results1.The score of quality of life:The mean CDLQI score of children with PWS was 3.077±3.371.PWS had the greatest impact on emotion and recreation and the least impact on sleep;the mean FDLQI score of mothers was 11.275±6.729,and the mean FDLQI score of fathers was 12.549±6.718,with no statistically significant difference(P<0.05).PWS had the greatest effect on both parties’ expenditures and the least effect on recreation.2.Related factors:There was a statistically significant difference in the effect of lesion type on the CDLQI scores of children with PWS(P<0.05)and there was a positive correlation between the two;the difference in the effect of gender,age,and skin lesion location on CDLQI scores was not statistically significant(P>0.05)3.Correlation analysis:There was a positive correlation between the CDLQI scores of the children and the FDLQI scores of their mothers,while there was no correlation with the FDLQI scores of their fathers.Conclusions1.PWS had varying degrees of impact on the quality of life of children with PWS and their parents,with the greatest impact on children’s emotion,recreation,and expenditures on their parents;2.The quality of life of children with PWS was related to skin lesion type,independent of gender,age,and skin lesion location;3.The quality of life of children with PWS was positively correlated with the quality of life of their mothers,but not the fathers.