Fluorescence Diagnosis with δ-Aminolevulinic Acid-Induced Porphyrins in Dermatology

Fritsch, Clemens; Lang, Kerstin; Schulte, K.-W.; Neuse, W.; Ruzicka, Thomas; Lehmann, Percy

doi:10.1007/978-3-662-04511-4_18

Cited by 9 publications

(11 citation statements)

References 29 publications

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“…Because PpIX has characteristic fluorescence properties, its preferential accumulation in certain cell types can be used as a cellular marker. In fluorescence diagnosis with ALA-induced porphyrins (FDAP), lesional and non-lesional skin are irradiated with blue light after incubation with 5-ALA. PpIX accumulating cells can be visualized, as PpIX shows red fluorescence when excited by blue light (1). In general, all PpIX accumulating skin disorders may be a potential target for fluorescence diagnosis.…”

Section: Introductionmentioning

confidence: 99%

The effects of keratolytic pretreatment prior to fluorescence diagnosis and photodynamic therapy with aminolevulinic acid-induced porphyrins in psoriasis

Kleinpenning

Kanis

Smits

et al. 2009

Journal of Dermatological Treatment

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Section: Introductionmentioning

confidence: 99%

The effects of keratolytic pretreatment prior to fluorescence diagnosis and photodynamic therapy with aminolevulinic acid-induced porphyrins in psoriasis

Kleinpenning

Kanis

Smits

et al. 2009

Journal of Dermatological Treatment

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“…Macroscopic fluorescence intensity after incubation with ALA has been shown to differ in various skin diseases. Psoriasis has been reported to have the highest macroscopic fluorescence values but homogenicity appears to be a problem when lesions are not pretreated with a keratolytic agent (Fritsch et al, 2000). Macroscopic fluorescence intensity and intralesional PpIX content after ALA incubation have been studied by Fritsch et al (1999).…”

mentioning

confidence: 99%

“…As PpIX has characteristic fluorescence properties, its preferential accumulation in certain cell types can also be used as a cellular marker. In fluorescence diagnosis with ALA-induced porphyrins (FDAP), lesional and non-lesional skin is irradiated with blue (Wood's) light after incubation of the skin with ALA. As PpIX shows red fluorescence when excited by blue light, PpIX accumulating cells can be visualized after irradiation with Wood's light (Fritsch et al, 2000). In cases where demarcation of lesional skin is clinically problematic or in dermatological screening of field cancerized skin, FDAP may provide additional information.…”

mentioning

confidence: 99%

Correlation Between Macroscopic Fluorescence and Protoporphyrin IX Content in Psoriasis and Actinic Keratosis Following Application of Aminolevulinic Acid

Smits

Robles

Erp

et al. 2005

Journal of Investigative Dermatology

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In fluorescence diagnosis with 5-aminolevulinic acid (ALA)-induced porphyrins (FDAP), protoporphyrin IX (PpIX) accumulation can be macroscopically visualized. Interpretation of these data is still problematic because of the low reproducibility of the procedure and poor understanding of the mechanisms involved in PpIX tumor selectivity. In this study, PpIX accumulation is investigated in patients with psoriasis and actinic keratosis (AK) following FDAP. For this purpose, desquamated lesional and non-lesional skin were incubated with 20% ALA ointment for 3 h, FDAP was performed, and highly fluorescing lesional skin and non-lesional skin were biopsied. In extracts from these biopsies, PpIX, protein, and dsDNA were quantified by spectrofluorometry. Digital images acquired with FDAP were analyzed using image analysis software. PpIX per biopsy in lesional skin in both psoriasis and AK was significantly higher than in non-lesional skin (p < 0.05). When corrected for epidermal involvement, only lesional psoriatic skin showed significantly higher PpIX levels than non-lesional skin. The PpIX-ratio lesional:non-lesional skin (mean(pmol per mL)+/-SEM) was 4.12+/-0.91 in psoriasis and 1.96+/-0.24 in AK. In FDAP, the ratio of lesional:non-lesional skin was 1.77+/-0.06 in psoriasis and 1.37+/-0.07 in AK. Macroscopic fluorescence and PpIX content appeared to be well correlated (r = 0.73), thus making FDAP a good predictor of PpIX content.

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“…After topical application of ALA or MAL on the skin lesional and non-lesional areas, they are irradiated with blue light (408 nm). As PpIX shows red fluorescence when excited by blue light, PpIX accumulating cells can be visualized [32]. The detection of skin surface fluorescence can be made either by using simple handheld Wood's lamp (long wave UVA) or by using CCD camera systems coupled to digital imaging and helps the clinician to differentiate lesions and perform either a guided biopsy or a controlled and complete resection of tumor, or even to identify persistent or recurrent disease.…”

Section: Cutaneous Fluorescence Diagnosismentioning

confidence: 99%

Photodynamic Therapy and Skin Cancer

Papakonstantinou¹,

Löhr²,

Raap³

2018

Dermatologic Surgery and Procedures

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Non-melanoma skin cancer (NMSC) is the most common type of cancer among white skin individuals worldwide with an increasing incidence over the last years. NMSC is mostly treated with surgical or non-invasive methods such as cryotherapy or topical chemotherapeutics. Over the last years, there has been a rapidly growing interest in the use of photodynamic therapy (PDT) which is a well-tolerated, safe and effective alternative treatment option. PDT involves a photosensitizer, a light source and tissue oxygen and is based on a photo-oxidation reaction in the target tissue which results to a selective destruction of the cancer cells. PDT has been approved for treatment of actinic keratosis, Bowen's disease and basal cell carcinoma in Europe. Off-label uses include treatment of invasive squamous cell carcinoma, cutaneous T-cell lymphoma, Kaposi's sarcoma, Paget's disease and prevention of recurrence of squamous cell carcinoma in organ-transplant recipients. Also combination of PDT with other treatment options such as cryotherapy, surgery and topical therapies has been reported with improved efficacy, tolerability and long-term results. Development of novel photosensitizers and light sources together with targeted delivery systems will increase specificity, efficiency and treatment field of PDT in the future. This chapter aims to give the reader an overview of the important applications of PDT, including indications, approved treatments, advantages and disadvantages of this method such as future trends.

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Fluorescence Diagnosis with δ-Aminolevulinic Acid-Induced Porphyrins in Dermatology

Cited by 9 publications

References 29 publications

The effects of keratolytic pretreatment prior to fluorescence diagnosis and photodynamic therapy with aminolevulinic acid-induced porphyrins in psoriasis

The effects of keratolytic pretreatment prior to fluorescence diagnosis and photodynamic therapy with aminolevulinic acid-induced porphyrins in psoriasis

Correlation Between Macroscopic Fluorescence and Protoporphyrin IX Content in Psoriasis and Actinic Keratosis Following Application of Aminolevulinic Acid

Photodynamic Therapy and Skin Cancer

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