Efficacy prediction model of hematoporphyrin monomethyl ether photodynamic therapy for facial port-wine stains.

Purpose: This study aimed to identify factors influencing photodynamic therapy (PDT) efficacy in facial port-wine stains (PWS) and to develop a predictive model for treatment outcomes.

Methods: A retrospective analysis was conducted on 863 patients with facial PWS who had undergone hematoporphyrin monomethyl ether photodynamic therapy (HMME-PDT). Multivariate logistic regression analysis was employed to identify factors influencing efficacy and to construct a nomogram prediction model.

Results: A total of 265 patients (30.7%) obtained excellent results while 598 patients (69.3%) did not. The influencing factors identified included age, PWS location, type of PWS, prior treatment history, number of PDT sessions, and vascular and non-vascular features observed via dermoscopy. Receiver operating characteristic curve analysis revealed that the area under the curve for the training and validation cohorts was 0.80 and 0.81, respectively. The calibration curve closely approximated the ideal diagonal line, and the Hosmer-Lemeshow test indicated a good fit for the model in both the training (p = 0.73) and validation cohorts (p = 0.52). Clinical decision curve analysis demonstrated a significantly improved net benefit in both cohorts.

Conclusions: Our findings provide dermatologists with an accurate and effective tool for predicting PDT efficacy, facilitating the individualized management of facial PWS.