Photodynamic therapy with green light for the treatment of vulvar lichen sclerosus - Preliminary results.

INTRODUCTION: The standard treatment for lichen sclerosus (LS) is symptomatic and is primarily based on the chronic use of corticosteroids, sometimes resulting in unsatisfactory effects. Therefore, other non-pharmacological methods are being sought, which are less aggravating for the patient. LS can be treated topically by using photodynamic therapy (PDT) based on 5-aminolevulinic acid (5-ALA). Unfortunately, therapy with the red light is often connected with severe local pain during the illumination. Green light can also be characterised by its ability to turn on photodynamic reactions in cells. MATERIALS AND METHODS: The aim of this study was an evaluation into the efficacy and tolerance of 5-ALA-PDT with a green light (540nm±15nm) in 11 patients with chronic LS that were characterised by severe itching. The disease lasted from 1.5 to 4 years. All the patients were treated with three sessions of PDT. RESULTS: Following treatment with PDT, a significant improvement of local status, as well as a reduction of the main symptom (pruritus), were observed. No patient complained of severe pain during the sessions that would have required an interruption of irradiation or local application of analgesics. CONCLUSIONS: Our preliminary results of using green light in PDT for superficial skin non-oncological lesions are very promising but require further studies.

Photodynamic therapy of vulvar lichen sclerosus et atrophicus in a woman with hypothyreosis--case report.

Lichen sclerosus et atrophicus (LSA) is disease of skin and mucosa, its pathogenesis remains unknown. Itching, pain and burning sensations and atrophy of vulva impair quality of life. Treatment is symptomatic. We report case of 30-year old woman with lesions in vulva in which series of topical PDT were carried out. We applied Levulan®Kerastick® for 4h and after that lesions were illuminated with red light. Along with above treatment patient started receiving Euthyrox®, because of recently diagnosed hypothyreosis. Significant relief from subjective symptoms was achieved and lesions in vulvar region disappeared. Combination of topical PDT with hormonal therapy allowed controlling course of disease and minimizing symptoms, and thus improved quality of life.

[The evaluation of the relationship between malignancy grade and cytokeratin-10 accumulation in human skin squamous cell carcinoma]. / Ocena zaleznosci pomiedzy stopniem dojrzalosci histologicznej w ludzkim raku kolczystokomórkowym skóry a obecnoscia CK-10.

The aim of the study was analysis of CK-10 expression in human skin squamous cell carcinoma (SCC) basing on immunohistochemical procedure. The study was carried out on 43 samples of skin SCC which were evaluated histopathologically with regard to 3-grade scale (G) of malignancy. In each case immunohistochemical reactions by use of ABC method were carried out in order to detect CK-10 within cancer cells. The expression of CK-10 was evaluated in accordance with arbitrary 3 grade scale: from +++ to +. The obtained results revealed affection of CK-10 expression in cancer cells. In G1 and G2 skin SCC a moderate expression of CK-10 was found and this occurred in cells grouped in nests. In G3 SCC the expression of CK-10 was very low and this was noted in single cells only. The use of immunohistochemical methods in evaluation of CK-10 expression can be a useful tool in routine histopathologic examination of tumors of epithelial origin.

[Analysis of basement membranes status in skin squamous cell carcinoma (SCC)]. / Analiza stanu blon podstawnych w raku kolczystokomórkowym skóry (SCC).

The aim of study was analysis of basal membranes in skin squamous cell carcinoma (SCC) basing on immunoreactivity of basal membrane component--laminin. The study was carried out on 43 samples of skin SCC which were evaluated histopathologically with regard to 3-grade scale (G) of malignancy. In each case immunohistochemical reactions by use of ABC method were carried out in order to detect laminin within basal membranes. The amount of laminin in basal membranes was evaluated semiquantitatively thus enabling to distinguish 3 groups of SCC: with abundant, moderate and small amount of laminin. The obtained results revealed significant differences within basal membranes according to malignancy grade. Most frequent anomalies referred to differences in basal membranes regularity, thickness and quantitative changes. In group of cancers with abundant laminin the number of tumor nests surrounded with mostly well formed basal membranes was found. Cancers with moderate laminin revealed variously formed basal membranes with distinct morphologic alterations and local gaps in continuity. In group of cancers with small laminin solely remnants of basal membranes were found. The results of present study indicated predominance of moderate amount of basal membranes in skin G1-2 SCC and small amount of basal membranes in poorly differentiated G3 SCC. The use of immunohistochemical methods in evaluation of laminin expression can be a useful tool in routine histopathologic examination of tumors of epithelial origin.

Tumor histopathology following new sensitizers: dithiaporphyrin- and sulfoxaporphyrin-mediated photodynamic therapy.

BACKGROUND: Our main aim was to evaluate tumor histopathology following new sensitizer-mediated photodynamic therapy (PDT). MATERIALS AND METHODS: In order to complete our studies we decided to use photosensitizers, i.e. dithiaporphyrin (DTP) and sulfoxaporphyrin (OXA) in combination with halogen lamp irradiation of presensitized tumors. The doses of sensitizers were: 2.5, 5.0, 7.5 and 10.0 mg/kg of body weight and total light doses were: 50, 100 and 150 J/sq.cm at the selected wavelength. Following such a treatment we have evaluated tumor necrosis of BFS1 fibrosarcoma growing on BALB/c mice. Together with tumor necrosis evaluation we have examined skin response to photodynamic treatment. RESULTS: We have found that both new sensitizers caused significant tumor damage at no skin alterations. The induction of tumor necrosis seemed to be dose dependent, i.e. higher photodynamic doses (sensitizer dose x light dose) resulted in more severe damage to the tumors than the lower doses. CONCLUSION: Our study showed that BFS1 fibrosarcoma is highly sensitive to PDT after application of new sensitizers. Both compounds can be considered as potent tumor photosensitizers in future clinical trials.

Photodynamic treatment of epithelial tissue derived from patients with endometrial cancer: a contribution to the role of laminin and epidermal growth factor receptor in photodynamic therapy.

Photodynamic therapy (PDT) was used to treat endometrial G1 cancer tissue derived from patients who had undergone a total hysterectomy and bilateral salpingo-oophorectomy. After surgical treatment the cancerous tissue was kept in a medium containing Dulbecco solution, fetal calf serum, and antibiotics. The tissue was then exposed to hematoporphyrin derivative (0.1 mg/ℓ) and 24 h later exposed to light (total light dose-18 J/sq cm). Necrosis depth was evaluated 24 h later using a light microscope. In order to assess the possible role of the basal membrane component laminin, as well as epidermal growth factor receptor susceptibility to PDT, immunohistochemical studies were carried out. Additionally, nucleolar organizer regions evaluation was performed. Our experiment confirmed that PDT results in the necrosis in the treated endometrial cancer, while not affecting the laminin in the cancerous tissue. In contrast, PDT strongly affects the epidermal growth factor receptor and nucleolar organizer regions in cancer cells. We suggest that laminin may contribute to the prevention of cancer dissemination in the cases where PDT has to be repeated, and that after PDT the cells become less susceptible to a mitogen, like, e.g., epidermal growth factor. © 1999 Society of Photo-Optical Instrumentation Engineers.

5-Aminolevulinic acid photodynamic therapy of transplantable colon adenocarcinoma in BALB/c mice.

We present results of preliminary studies on 5-aminolevulinic acid (5-ALA)-photodynamic therapy (PDT). In order to assess the effectiveness of 5-ALA-PDT we have used BALB/c mice transplanted subcutaneously with mouse colon adenocarcinoma C51. 5-ALA in the dose of 50 mg/kg was given intraperitoneally and 5 h later tumors were exposed to light at total doses from 50 to 75 J/cm2, wavelength 630+/-20 nm and light intensity 200 mW/cm2. Several time points following 5-ALA injections have been used to measure protoporphyrin IX (PpIX) concentration in different tissues from unirradiated mice. PDT effects were evaluated with regard to survival time, tumor response and necrosis depth. The main finding in our tumor model was that the optimum tumor to skin ratio of PpIX occurs within 5 h after sensitizer injection. 5-ALA-PDT resulted in prolongation of survival time of treated mice as compared to control animals and, in some cases, in complete response of tumors. PDT also caused increase in tumor necrosis, while no skin photodamage was observed.