PDT is an effective treatment for low-risk BCC, with excellent cosmesis and safety. Imiquimod has higher efficacy than single-cycle PDT but more adverse effects. Highest efficacy is with excisional surgery. Fractionated and combination PDT options warrant further study.

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Topical PDT is usually well tolerated, reinforcing the utility of this important therapeutic option in dermatology practice. The main acute adverse effect of pain can typically be minimized through preventative approaches of modified PDT regimens. Other adverse effects are uncommon and generally do not limit treatment delivery.

Background Levodopa‐induced dyskinesias are an often debilitating side effect of levodopa therapy in Parkinson's disease. Although up to 90% of individuals with PD develop this side effect, uniformly effective and well‐tolerated antidyskinetic treatment remains a significant unmet need. The pathognomonic loss of striatal dopamine in PD results in dysregulation and disinhibition of striatal CaV1.3 calcium channels, leading to synaptopathology that appears to be involved in levodopa‐induced dyskinesias. Although there are clinically available drugs that can inhibit CaV1.3 channels, they are not adequately potent and have only partial and transient impact on levodopa‐induced dyskinesias. Methods To provide unequivocal target validation, free of pharmacological limitations, we developed a CaV1.3 shRNA to provide high‐potency, target‐selective, mRNA‐level silencing of striatal CaV1.3 channels and examined its ability to impact levodopa‐induced dyskinesias in severely parkinsonian rats. Results We demonstrate that vector‐mediated silencing of striatal CaV1.3 expression in severely parkinsonian rats prior to the introduction of levodopa can uniformly and completely prevent induction of levodopa‐induced dyskinesias, and this antidyskinetic benefit persists long term and with high‐dose levodopa. In addition, this approach is capable of ameliorating preexisting severe levodopa‐induced dyskinesias. Importantly, motoric responses to low‐dose levodopa remained intact in the presence of striatal CaV1.3 silencing, indicating preservation of levodopa benefit without dyskinesia liability. Discussion The current data provide some of the most profound antidyskinetic benefit reported to date and suggest that genetic silencing of striatal CaV1.3 channels has the potential to transform treatment of individuals with PD by allowing maintenance of motor benefit of levodopa in the absence of the debilitating levodopa‐induced dyskinesia side effect. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Photodynamic therapy (PDT) is an established treatment option for low-risk basal cell carcinoma (BCC). BCC is the most common human cancer and also a convenient cancer in which to study PDT treatment. This review clarifies challenges to researchers evident from the clinical use of PDT in BCC treatment. It outlines the context of PDT and how PDT treatments for BCC have been developed hitherto. The sections examine the development of systemic and subsequently topical photosensitizers, light delivery regimens, and the use of PDT in different patient populations and subtypes of BCC. The outcomes of topical PDT are discussed in comparison with alternative treatments, and topical PDT applications in combination and adjuvant therapy are considered. The intention is to summarize the clinical relevance and expose areas of research need in the BCC context, ultimately to facilitate improvements in PDT treatment.

Photodynamic therapy (PDT) is an established treatment for superficial basal cell carcinoma (BCC). Organ transplant recipients (OTRs) are at increased risk of BCC. We investigated the efficacy of PDT in OTRs and compared the recurrence rate to the non-transplanted population. We conducted a retrospective casenote review of all patients undergoing PDT for the treatment of BCC in our centre from 2003 to 2013. Three hundred and twenty-two BCCs from 103 patients underwent PDT during this period. There is no significant difference in BCC recurrence following PDT in OTRs (22.6 %) versus non-transplant patients (15.2 %) (p = 0.18). PDT is an efficacious treatment for BCC in OTRs with no significant evidence of inferiority compared to non-transplanted patients. Our findings require corroboration in a larger study.

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SummaryFolliculitis decalvans (FD) is classified as a primary neutrophilic cicatricial alopecia, and is estimated to account for approximately 10% of all cases of primary cicatricial alopecia. 1 The role of dysfunctional immune activity and the presence of bacteria, particularly Staphylococcus aureus, appear pivotal. We describe a 26-year-old man with a 4-year history of FD that was recalcitrant to numerous systemic and topical therapies, whose disease was virtually cleared during a follow-up of 25 months following a course of treatment with systemic photodynamic therapy (PDT) using ultraviolet light (100-140 J/cm 2 ) with porfimer sodium 1 mg/kg as monotherapy. This is the first report of the use of systemic PDT as a treatment for FD. Systemic PDT has potent antibacterial effects with little or no resistance. In addition, systemic PDT provides local immunomodulation and improved scar healing. Significant adverse effects following systemic PDT with appropriate aftercare are rare. This case demonstrates that systemic PDT is a useful therapy option in the treatment of recalcitrant FD.Folliculitis decalvans (FD) is classified as a primary neutrophilic cicatricial alopecia, which accounts for approximately 10% of all cases of primary cicatricial alopecia.1 Dysfunctional immune activity and the presence of bacteria, particularly Staphylococcus aureus, appear to play pivotal roles. We report a case of FD in a young man who was successfully treated with systemic photodynamic therapy (PDT). ReportA 26-year-old man presented in 2011 with a 4-year history of waxing and waning painful pustulation, hair tufting and scarring, all affecting the vertex of the scalp. He was otherwise healthy. Histological examination of a biopsy taken from the scalp showed evidence of scarring alopecia with superficial follicular and perifollicular abscesses (Fig. 1a). Staining showed Numerous gram-positive bacteria within inflamed hair follicles, and an absence of fungi were evident. Multiple microbacterial swabs from active scalp pustules grew methicillin-sensitive S. aureus. Fungal cultures were negative, as was a screen of connective tissue and skin autoantibodies for bullous pemphigoid and pemphigus.Treatment over the next 3 years involved oral antibiotics (doxycycline, rifampicin and clindamycin), retinoids (isotretinoin and acitretin), prednisolone and ciclosporin. Topical treatments included antibacterial washes, topical antibiotics and topical corticosteroids. Despite these treatments, the disease remained active, with a significant impact on quality of life. The patient was referred for consideration of radiotherapy, a treatment with previously demonstrated effectiveness in FD. 2During the assessment, the patient's youth made it preferable to avoid radiotherapy and instead he was offered a trial of systemic PDT with porfimer sodium (Photofrin, Axcan Pharma Inc, Quebec, Canada) as a novel alternative.