Current Insights Into The Management Of Discoid Lupus Erythematosus.

Discoid lupus erythematosus is the most disfiguring and common presentation of chronic cutaneous lupus erythematosus. Although most patients will respond to lifestyle measures and topical treatment, a non-negligible number of patients will require systemic and physical therapy, either alone or in combination. We performed a review of the available evidence on the discoid lupus erythematosus treatment. Lifestyle measures and topical treatment (corticosteroids and topical calcineurin inhibitors) remain the therapeutic strategies with the highest evidence level. Within systemic treatment approaches, antimalarial drugs are still the first-line therapy, while other systemic and physical therapies have highly variable evidence. Hence, we propose a therapeutic algorithm based on the strength of recommendations of the different treatment modalities, focusing on the refractory disease.

Treatment of Bowen's disease with photodynamic therapy. Observational study in 171 patients with 5-aminolaevulinic acid (BF-200 ALA) and methyl aminolaevulinate (MAL).

An observational study was carried out in the photodynamic therapy (PDT) section of Fuenlabrada's hospital (Madrid, Spain). Our goal was to investigate the efficacy and safety of PDT in Bowen's disease (BD). Between June 2011-June 2017 171 patients (191 lesions) with diagnosis of BD were enrolled in the study (95 women and 76 men; average age of 74.31 years). Lesions were treated with one 5-aminolaevulinic acid (BF-200 ALA)-PDT or methyl-5-aminolaevulinate (MAL)-PDT cycle of two sessions in one week. A second treatment cycle was performed in cases of clinical persistence at 12 weeks. Our results showed that 47/55 lesions were resolved (84.75%) after one or two ALA-PDT cycle and 75/136 lesions (55.15%) after one or two MAL-PDT cycles, in the 12-month follow-up. In conclusion PDT is a safe and non-invasive treatment option in BD. In addition, our results suggest a better response with ALA-PDT over MAL-PDT. Limits: observational study with a limited number of patients.

Treatment of superficial basal cell carcinoma with photodynamic therapy. Observational study in 22 patients with 5-aminolaevulinic acid and methyl aminolaevulinate.

BACKGROUND: There is limited literature on efficacy in 5-aminolaevulinic acid (BF-200 ALA) and methyl-5-aminolaevulinate (MAL) for superficial basal cell carcinoma (sBCC). AIMS: To investigate the efficacy and safety of PDT in sBCC. METHODS: Analytical observational study between January 2014 and January 2017. Follow-up at 12, 24 and 52 weeks. Lesions were treated with one BF-200 ALA-PDT or MAL-PDT cycle of two sessions in one week. A second treatment cycle, with the same photosensitizer precursor, was performed in cases of clinical persistence at 12 weeks. RESULTS: A total of 22 patients (30 lesions) were enrolled in the study. By sex, 13 men and 9 women. Average age of 72,14 years. In the 12-month follow-up 15/16 lesions were resolved (93,75%) after one or two BF-200 ALA-PDT cycle and 7/14 lesions (50%) after one or two MAL-PDT cycles. In most patients, tolerance to the therapy was good or regular, with no differences between the two groups. No long-term adverse effects were reported. LIMITATIONS: The observational nature and the low number of patients. CONCLUSION: PDT is a safe and non-invasive treatment option in sBCC. Our results suggest a better response with BF-200 ALA-PDT over MAL-PDT, at 12 months of follow-up.