PDT was beneficial in the treatment of acne. As a photoactivating light source, polychromatic visible light was thought to be better for use with acne patients than laser light because of its cost-effectiveness, uniform illumination and time-efficiency in treating large areas.

Japanese woman presented with a 10year history of intractable acne vulgaris lesion on her face. The lesions coincided with her menstrual cycle, and resisted various treatments including 1% nadifloxacin cream, clindamycin hydrochloride lotion, and chemical peeling with glycolic acid and other agents.

Based on the opinion that 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) may be disadvantageous to Oriental patients with dark skin, including Japanese, because the competing chromophore melanin inhibits the photochemical reaction, we assessed the therapeutic effects when Japanese AK were treated with ALA-PDT. Fifty-three lesions in ten patients were followed up for over one year. The cure rates of AK on the face including the neck and on extremities were 81.8% and 55.6%, respectively. The results were approximately the same cure rates as those reported for AK in Caucasian patients. However, a larger number of treatment sessions were required. In the red light range, incoherent light including 630 nm and 670 nm is superior to 630 nm laser light.

A 74-year-old woman with extensive inoperable vulval extramammary Paget's disease who had lymph node and pulmonary metastases, was treated with etoposide (VP16) 100 mg and 5000 cGy electron beam irradiation, which reduced the lesion by 60%. Following these interventions, the residual lesion was successfully treated with repeated photodynamic therapy using delta-aminolaevulinic acid, which achieved a nearly complete remission.

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5-Aminolevulinic acid-based photodynamic therapy (ALA-PDT) in the standard manner is ineffective for pigmented basal cell carcinoma (pBCC), because melanin absorbs the photoactivating light interred for protoporphyrin IX. The objective of this study was to assess the therapeutic outcome of pBCCs with repeated ALA-PDT following removal of pigmentation with electro-curettage. After electro-curettage, 16 pBCCs were treated with a combination of topical application of 20% ALA in O/W emulsion and topical instillation of 10% ALA solution, followed by photoactivating light. ALA-PDT was performed more than three times. Fourteen of 16 pBCCs showed CR. Two pBCCs showing PR or NR were excised. Repeated ALA-PDT following electro-curettage was effective for pBCC.

In order to investigate the effect of occlusion on the skin, the flexor sides of both upper arms were covered with column-shaped with column-shaped closed chambers, 30 mm in outer diameter, 20 mm in inner diameter, and 5 mm in height, which were made of polyethylene foam. The tops of the chambers were sealed by plastic films with various levels of water vapor permeability to control moisture in each chamber. The raised chamber walls prevented direct contact between the skin and the plastic film. After 24 h of application, morphological changes of the skin surface were observed microscopically by the nitrocellulose-replica method. Although no visual alterations were found on all areas of occluded skin, microscopic evaluation showed that simple occlusion by films induced an increase in the number of deepened skin furrows on the skin surface. this increase was associated with lower water vapor permeability of the films, as well as with higher values of both temperature and humidity of the test day. Thus, since conditions which facilitate perspiration from the skin tend to cause skin irritation, prolonged exposure of the skin to sweat by simple occlusion may act as a primary skin irritant.

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