A Critical Reappraisal of Off-Label Use of Photodynamic Therapy for the Treatment of Non-Neoplastic Skin Conditions

Abstract

Background: In the past 30 years, topical photodynamic therapy (PDT) has been investigated for the treatment of a broad spectrum of cosmetic, inflammatory, and infectious skin conditions with variable, and often contrasting, results. However, the non-expert clinician may be in difficulty evaluating these results because different sensitizers, concentrations, formulations, light sources, and irradiation protocols have been used. In addition, many of these studies have poor quality design being case reports and uncontrolled studies of few cases. Summary: With the aim to clarify the potential usefulness of PDT for the treatment of infectious and inflammatory skin diseases as well as selected cosmetic indications, we searched for randomized controlled clinical trials, non-randomized comparative studies, retrospective studies, and case series studies with a number of at least 10 patients, published since 1990. Later, we reappraised the results in order to give a simple critical overview. Key Messages: Evidence from the literature seems to strongly support the use of ALA- and MAL-PDT for the treatment of common skin diseases such as acne, warts, condylomata, and Leishmania skin infection and for photorejuvenation, i.e., the correction of selected cosmetic changes of aging and photoaging. For other disorders, the level of evidence and strength of recommendation are lower, and controlled randomized studies with prolonged follow-ups are necessary in order to assess the clinical usefulness and other potential advantages over current treatment options.

Chalcogen Effects in the Photophysical Properties of Dimethylamino-1,8-naphthalimide Dyes Revealed by DFT Investigation

“…Photodynamic therapy (PDT) is an approved noninvasive medical treatment used against a consistent number of diseases − among which are different kinds of cancer, − bacterial, viral and fungal infections, , dental caries, rheumatoid arthritis, cardiovascular disorders, and cutaneous manifestations . Compared to chemotherapy, its use in anticancer therapy produces less side effects, and its high selectivity is enhanced by an invoked immune response which causes a mixture of apoptotic and necrotic cell death. , For these reasons, basic and applied research aimed at proposing new drugs for PDT treatment has increased considerably over the last three decades, − also with the aim of overcoming some of the most important limitations of current PDT, namely hypoxia and poor light penetration, focusing in particular on metallic dyes to abandon the use of traditional tetrapyrrolic structures. , …”

Leg paralysis after photodynamic therapy for lymphomatoid papulosis: A case report

“…In conclusion, PDT is generally a safe and non-invasive technique in malignant and inflammatory diseases, [7][8][9] but this case highlights the possibility that for particular localizations and irradiating power, PDT may also be harmful to noble tissues such as the nervous one.…”

Accelerating skin regeneration and wound healing by controlled ROS from photodynamic treatment

“…Photodynamic therapy (PDT) has been applied for cancer treatment, infections, and inflammatory situations, such as acne, rosacea, and genital warts [1]. PDT defines as a mixture of a chemical compound, known as a photosensitizer (PS), and light at specific wavelengths which led to a series of photochemical reaction that subsequently leads to cellular damage [2].…”