Hemoporfin-Mediated Photodynamic Therapy-Caused Skin Barrier Damage and Triggered Dermatitis in Port-Wine Stains.

Abstract

Background: Hemoporfin-mediated photodynamic therapy (PDT) is a high efficacy treatment alternative for port-wine stains (PWS) patients, and PDT also induced eczematous dermatitis in treated areas. However, the effect of PDT treatment on the prevalence and risk of dermatitis in patients with PWS have not been reported.

Purpose: To assess the association between PDT and dermatitis incidence and to investigate the mechanism of PDT-triggered dermatitis in PWS patients.

Patients and methods: A total of 512 PWS patients who received hemoporfin-mediated PDT treatment between June 2020 and September 2022 at the dermatology department of Wuhan No.1 Hospital were recruited in this study. Clinical images were used to calculate the percentage of dermatitis in treated areas. The arithmetic mean roughness (Ra), the average depth of roughness (Rz) and the mean square roughness (Rq) were used to assess the change of surface roughness. Transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total lipid content (TLC) were used to analyze the skin barrier function.

Results: After treatment, we found that 27.15% (139/512) of PWS patients developed dermatitis on the treated areas, and the percentage of dermatitis was closely related to the treatment times and age of the patient. Moreover, these treated areas also exhibited markedly increased skin roughness (Ra, Rz, Rq; p < 0.05) and impaired barrier function, evidenced by significantly elevated TEWL and TLC (p < 0.05) and reduced SCH (p < 0.05).

Conclusion: PDT caused skin barrier dysfunction in PWS patients, which may lead to increased permeability of the epidermis and contribute to the dermatitis development.