Abstract: Objective: To investigate the correlation between dermoscopic vascular features of port-wine stain (PWS) in children and efficacy of hematoporphyrin monomethyl ether-photodynamic therapy (HMME-PDT) for PWS. Methods: Clinical data of children with PWS treated with HMME-PDT of our hospital from March 2020 to December 2022 were retrospectively analyzed. Dermoscopic images of lesions were captured to classify vascular patterns. HMME (5 mg/kg) was intravenously injected, followed by irradiation with a 532 nm LED light source at 8-week intervals. Clinical efficacy and adverse events were recorded. Statistical analysis was performed using Stata 15.1 to assess the correlation between dermoscopic vascular types and therapeutic outcomes. Results: A total of 113 children (52 males, 61 females; age range 1 to 12 years) were included. Dermoscopic vascular patterns were classified into six types: linear (32 cases, 28.3%), dotted-globular (8 cases, 7.1%), short rod-like (29 cases, 25.7%), reticular (15 cases, 13.3%), mixed (18 cases, 15.9%), and homogeneous red background (11 cases, 9.7%). After three HMME-PDT sessions, the complete remission rates for these types were 100.0%, 65.5%, 59.3%, 20.0%, 16.7%, and 0.0%, respectively. The dotted-globular, short rod-like, and linear types showed significantly better efficacy compared to other types (P＜0.05). Conclusion: Dermoscopic vascular patterns are significantly correlated with HMME-PDT efficacy, dotted-globular, short rod-like and linear have better efficacy.

Key words: hematoporphyrin monomethyl ether, photodynamic therapy, children, port-wine stain, dermoscopy