Photodynamic therapy in treatment of port wine stain birthmarks--recent progress

Port wine stain (PWS) birthmarks are congenital vascular malformations characterized by ectatic capillaries in the papillary layer of the dermis. They usually appear at birth and tend to become darker and thicker with age. Cosmetic and pathological changes can cause great depression in all ages. Laser-mediated selective photothermolysis is the treatment of choice but vascular-targeted photodynamic therapy (PDT) might be an alternative approach in the treatment of PWS. PDT has shown therapeutic benefit in pink and resistant lesions. In theory, vascular-targeted PDT may be more efficient in terms of better lightening and less treatment sessions than pulsed dye laser (PDL) irradiation. Chinese clinicians have gained profound knowledge and accumulated a large body of clinical experience in PWS PDT in the past years. The pursuing of regulatory approval on PWS PDT is currently underway. In this article we will report our experience in PWS PDT, discuss current PDT protocols and introduce the novel combination therapy, such as PDT+PDL and PDT+topical angiogenic inhibitor.