ABSTRACT
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.
Subject(s)
Photochemotherapy/methods , Photosensitizing Agents/pharmacology , Photosensitizing Agents/therapeutic use , Anus Neoplasms/drug therapy , Anus Neoplasms/pathology , Autoimmune Diseases/drug therapy , Autoimmune Diseases/pathology , Eyelid Neoplasms/drug therapy , Eyelid Neoplasms/pathology , Female , Heat-Shock Proteins/biosynthesis , Humans , Infections/drug therapy , Infections/pathology , Inflammation/drug therapy , Inflammation/pathology , Mouth Diseases/drug therapy , Mouth Diseases/pathology , Neoplasms/drug therapy , Neoplasms/pathology , Neovascularization, Pathologic/drug therapy , Neovascularization, Pathologic/pathology , Paget Disease, Extramammary/drug therapy , Paget Disease, Extramammary/pathology , Photosensitizing Agents/administration & dosage , Singlet Oxygen/metabolism , Superoxides/metabolism , Up-RegulationABSTRACT
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.
Subject(s)
Facial Dermatoses/drug therapy , Indoleacetic Acids/administration & dosage , Keratosis, Actinic/drug therapy , Photochemotherapy/methods , Scalp Dermatoses/drug therapy , Administration, Cutaneous , Aged , Aged, 80 and over , Facial Dermatoses/diagnosis , Female , Humans , Keratosis, Actinic/diagnosis , Male , Photosensitizing Agents/administration & dosage , Pilot Projects , Scalp Dermatoses/diagnosis , Treatment OutcomeSubject(s)
Anetoderma , Adult , Anetoderma/classification , Anetoderma/pathology , Back/pathology , Biopsy , Diagnosis, Differential , Female , Humans , Torso/pathologySubject(s)
Keratosis , Precancerous Conditions , Ultraviolet Rays/adverse effects , Antineoplastic Agents/therapeutic use , Dermatologic Agents/therapeutic use , Diagnosis, Differential , Humans , Keratosis/etiology , Keratosis/pathology , Keratosis/therapy , Male , Neoplasms, Squamous Cell/etiology , Neoplasms, Squamous Cell/pathology , Precancerous Conditions/etiology , Precancerous Conditions/pathology , Precancerous Conditions/therapy , Skin/pathology , Skin Neoplasms/etiology , Skin Neoplasms/pathologyABSTRACT
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.
Subject(s)
Lymphoma, B-Cell/drug therapy , Photochemotherapy , Skin Neoplasms/drug therapy , Adult , Female , Humans , Male , Middle Aged , Pilot ProjectsSubject(s)
Allergens/adverse effects , Benzyl Alcohol/adverse effects , Dermatitis, Allergic Contact/diagnosis , Preservatives, Pharmaceutical/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Diagnosis, Differential , Female , Humans , Middle Aged , Patch Tests , Vulvovaginitis/drug therapyABSTRACT
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.