RESUMO
Photodynamic Therapy is a procedure based on the interaction between a Photosensitizer, a light source with a specific wavelength and oxygen. The aim of this review is to provide a brief and updated analysis of scientific reports on the use of PDT with topical PS in the management of oncological, infectious, and inflammatory disorders involving mucosal and semimucosal areas, with a specific focus on diseases of dermatologic interest.
Assuntos
Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Neoplasias do Ânus/tratamento farmacológico , Neoplasias do Ânus/patologia , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/patologia , Neoplasias Palpebrais/tratamento farmacológico , Neoplasias Palpebrais/patologia , Feminino , Proteínas de Choque Térmico/biossíntese , Humanos , Infecções/tratamento farmacológico , Infecções/patologia , Inflamação/tratamento farmacológico , Inflamação/patologia , Doenças da Boca/tratamento farmacológico , Doenças da Boca/patologia , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Neovascularização Patológica/tratamento farmacológico , Neovascularização Patológica/patologia , Doença de Paget Extramamária/tratamento farmacológico , Doença de Paget Extramamária/patologia , Fármacos Fotossensibilizantes/administração & dosagem , Oxigênio Singlete/metabolismo , Superóxidos/metabolismo , Regulação para CimaRESUMO
BACKGROUND: Actinic Keratoses (AK) are considered a form of in situ Squamous Cell Carcinoma (SCC) arising on chronically photoexposed skin. PDT with ALA or MAL is an effective treatment for multiple AK due its high Overall Response Ratio (ORR) but is burdened by important drawbacks: time-consumption, pain and high costs. Indole-3 acetic acid (IAA) is a newly described photosensitizer with proven clinical efficacy on seborrheic dermatitis and acne vulgaris. The aim of the study was to assess efficacy, safety and tolerability of a cycle of IAA-PDT at 0.015% in liposomal gel in the treatment of multiple AK of face or scalp. METHODS: We treated 12 patients affected by multiple AK on face/scalp with 4 weekly applications. The product was applied for 15min under occlusion; medicated area was then irradiated for 15min with a LED light at 520nm wavelength for a total fluency of 9J/cm2. RESULTS: No grade 3/4 SAE have been reported; all 12 patients successfully completed the cycle. CR at 3 months follow-up was 25%, with an ORR of 50%. Patients reported almost no pain during irradiations, with mean overall Visual Analogic Scale (VAS) score of 0.3±0.7. IAA-PDT led to a significant improve on Disease Life Quality Index (DLQI) mean score, but no variations on Actinic Keratosis Quality of Life (AKQoL) mean score. CONCLUSIONS: Although larger studies are needed, this is a first "proof of concept" of IAA- PDT as a possible treatment for multiple AK on face/scalp.
Assuntos
Dermatoses Faciais/tratamento farmacológico , Ácidos Indolacéticos/administração & dosagem , Ceratose Actínica/tratamento farmacológico , Fotoquimioterapia/métodos , Dermatoses do Couro Cabeludo/tratamento farmacológico , Administração Cutânea , Idoso , Idoso de 80 Anos ou mais , Dermatoses Faciais/diagnóstico , Feminino , Humanos , Ceratose Actínica/diagnóstico , Masculino , Fármacos Fotossensibilizantes/administração & dosagem , Projetos Piloto , Dermatoses do Couro Cabeludo/diagnóstico , Resultado do TratamentoAssuntos
Anetodermia , Adulto , Anetodermia/classificação , Anetodermia/patologia , Dorso/patologia , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Tronco/patologiaAssuntos
Ceratose , Lesões Pré-Cancerosas , Raios Ultravioleta/efeitos adversos , Antineoplásicos/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Humanos , Ceratose/etiologia , Ceratose/patologia , Ceratose/terapia , Masculino , Neoplasias de Células Escamosas/etiologia , Neoplasias de Células Escamosas/patologia , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/terapia , Pele/patologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologiaRESUMO
Photodynamic therapy (PDT) is a treatment based on the accumulation of a photosensitizer in the target cells and their selective destruction by irradiation with visible light. In the past 10 years, several patients with cutaneous T cell lymphoma have been successfully treated. The use of PDT in cutaneous B cell lymphoma has not been reported to date. We report the successful PDT treatment of 3 patients with early primary cutaneous B cell lymphoma.
Assuntos
Linfoma de Células B/tratamento farmacológico , Fotoquimioterapia , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos PilotoAssuntos
Alérgenos/efeitos adversos , Álcool Benzílico/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Conservantes Farmacêuticos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Testes do Emplastro , Vulvovaginite/tratamento farmacológicoRESUMO
Recently, numerous studies have been reported concerning the treatment of early-stage mycosis fungoides (MF) with narrowband (311-nm) UVB, claiming a beneficial response. We have used for the first time a 308-nm monochromatic excimer light, a new kind of xenon-chloride lamp, in the treatment of patch stage IA MF. We treated 7 patch lesions in 4 patients with unequivocal clinicopathologic diagnosis of MF. All lesions achieved clinical and histologic complete remission. The number of weekly sessions varied from 4 to 11 (mean 6.5; median 5.5). The total UVB 308-nm irradiation dose ranged from 5 to 9.3 J/cm(2) (mean 7.1 J/cm(2); median 7 J/cm(2)). All lesions remained in stable complete remission after a follow-up of 3 to 28 months. No remarkable side effects were reported. Our preliminary results suggest that monochromatic excimer light phototherapy is a possibly very useful treatment modality in patch stage IA MF.