{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T07:54:18Z","timestamp":1783065258801,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Some patients with port\u2010wine stain (PWS) who have undergone several sessions of pulsed dye laser (PDL) treatment desire further improvement through hematoporphyrin monomethyl ether (HMME) photodynamic therapy (PDT). We attempted to analyse a possible number of recommended sessions and factors influencing the efficacy of multiple sessions of HMME\u2010PDT for facial PDL\u2010resistant PWSs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010eight patients with facial PDL\u2010resistant PWSs who underwent at least three HMME\u2010PDT sessions were included in this study. All patients received an intravenous injection of HMME (5\u2009mg\/kg) followed by 532\u2010nm light\u2010emitting diode green light therapy. Cumulative improvement scores and single improvement scores were obtained after each session to evaluate the degree of improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The excellent improvement rates of patients were 0% (0\/48), 8.3% (4\/48), 29.2% (14\/48), 38.5% (10\/26), and 50.0% (8\/16) after 1\u20135 HMME\u2010PDT sessions, respectively. A significant difference was observed in the cumulative improvement scores (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Moreover, there were significant differences between any two sessions in the first four HMME\u2010PDT sessions (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). The improvement after the first HMME\u2010PDT session was more obvious than that after each subsequent session (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). A PWS less than or equal to 1% of the body surface area (OR\u2009=\u20099.05; 95% CI, 1.42\u201357.57; <jats:italic>p<\/jats:italic>\u2009=\u20090.020) and 5\u201310 sessions of previous PDL treatment (OR\u2009=\u20098.06; 95% CI, 2.01\u201332.33; <jats:italic>p<\/jats:italic>\u2009=\u20090.003) were positive influential factors for PDL\u2010resistant PWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We propose that at least 4 HMME\u2010PDT sessions could be recommended for patients with PDL\u2010resistant PWSs, and the improvement after the first HMME\u2010PDT session was the most evident compared with that after each subsequent treatment. Moreover, greater erythema and a greater number of previous PDL session were associated with poor HMME\u2010PDT efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.70003","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:39:41Z","timestamp":1742276381000},"page":"312-320","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Possible Number of Recommended Sessions and Influential Factors of Hematoporphyrin Monomethyl Ether Photodynamic Therapy for Pulsed Dye Laser\u2010Resistant Facial Port\u2010Wine Stain"],"prefix":"10.1002","volume":"57","author":[{"given":"Yating","family":"Lv","sequence":"first","affiliation":[{"name":"Qilu Hospital of Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luan","family":"Yang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Shandong First Medical University Tai'an 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