Fractional Carbon Dioxide Laser Improves Nodular Basal Cell Carcinoma Treatment with Photodynamic Therapy with Methyl 5-Aminolevulinate

Lippert, Jan; Smucler, Roman; Vlk, Marek

doi:10.1111/dsu.12242

Cited by 58 publications

(47 citation statements)

References 27 publications

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“…Another study looked at 56 nodular BCCs each of which was ablated using a gallium arsenide 980-nm diode laser under ultrasound control [26]. Three weeks later, half of each BCC then received CO 2 -AFXL, the other half curettage immediately prior to treatment with ALA-PDT.…”

Section: Basal Cell Carcinomamentioning

confidence: 99%

Laser-assisted drug delivery in dermatology: from animal models to clinical practice

Ali

Al‐Niaimi

2015

Lasers Med Sci

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Topical medicaments are the mainstay of the dermatologists' therapeutic arsenal. Laser-assisted drug delivery enhances the ability of topically applied medicaments to penetrate the skin. We discuss the mechanisms of laser-assisted drug delivery and animal models that have informed clinical practice. We review clinical studies that have employed laser-assisted drug delivery for a range of indications to date including non-melanoma skin cancer, vitiligo, scarring, vaccination, local anaesthesia, analgesia, viral warts, infantile haemangiomas and cosmetic uses. Studies thus far suggest that laser pre-treatment improves transepidermal absorption of topical agents and allows for a much deeper penetration of drugs than is possible with topical medicaments alone. This may allow more efficacious action of current treatments, such that conventional duration of treatment can be shortened or lower concentrations of active agents be used, potentially obviating side effects of treatment. The prospect of using laser technologies to facilitate transdermal vaccination and as an adjunct for inflammatory dermatoses and cosmetic indications remains in its infancy. As larger trials are published, involving greater numbers of patients and utilising various laser and topical medicament parameters, we will enhance our understanding of this nascent modality of treatment delivery.

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Section: Basal Cell Carcinomamentioning

confidence: 99%

Laser-assisted drug delivery in dermatology: from animal models to clinical practice

Ali

Al‐Niaimi

2015

Lasers Med Sci

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“…It is well known that pretreatment of skin with ablative fractional laser (AFL) enhances the uptake and aids topically applied photosensitizer precursors to distribute into skin layers [1][2][3][4][5]. In vivo animal studies and clinical studies have confirmed that AFL pretreatment successfully facilitates an intensified PDT response [1,[6][7][8][9][10][11][12][13][14][15]. Internationally, AFL-mediated PDT is gaining clinical acceptance.…”

Section: Introductionmentioning

confidence: 99%

“…This finding indicates that low channel densities should be sufficient to facilitate uniform accumulation of PpIX. However, clinical studies on AFL-mediated PDT have applied a wide range of densities from 5% to 22% [6,7,[10][11][12][13]15,22]. Limited information is available on pharmacokinetics for MAL uptake and biodistribution in AFL pretreated skin.…”

Section: Introductionmentioning

confidence: 99%

Ablative fractional laser enhances MAL-induced PpIX accumulation: Impact of laser channel density, incubation time and drug concentration

Haak

Christiansen²,

Erlendsson

et al. 2016

Journal of Photochemistry and Photobiology B: Biology

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“…Previously, ALA-PDT could not be used as a treatment for nodular basal cell carcinoma because these tumors were thicker than 2 mm. However, Lippert et al [14] showed that ALA-PDT with ablative laser therapy could overcome the limit caused by tumor thickness in patients with nBCC as the increased penetration allowed ALA to reach deep enough into the tumor layers. Yin et al [15] evaluated the effects of erbium: yttrium-aluminum-garnet (Er:YAG) ablative fractional laser resurfacing for treatment of severe acne.…”

Section: Improvements In Ala Penetrationmentioning

confidence: 99%

Current Advances in 5-Aminolevulinic Acid Mediated Photodynamic Therapy

et al. 2016

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Kennedy and Pottier discovered that photodynamic therapy (PDT) could be carried out using a procedure consisting of topical application of the porphyrin-precursor, 5-aminolevulinic acid (ALA) to the skin, followed after some time by illumination with various light parameters in the 1980s. Since then, ALA-PDT has expanded enormously and now covers most aspects of dermatological disease. The purpose of this review is to discuss a range of ingenious strategies that investigators have devised for improving the overall outcome (higher efficiency and lower side effects) of ALA-PDT. The big advance of using ALA esters instead of the free acid to improve skin penetration was conceived in the 1990s. A variety of more recent innovative approaches can be divided into three broad groups: (a) those relying on improving delivery or penetration of ALA into the skin; (b) those relying on ways to increase the synthesis of protoporphyrin IX inside the skin; (c) those relying on modification of the illumination parameters. In the first group, we have improved delivery of ALA with penetration-enhancing chemicals, iontophoresis, intracutaneous injection, or fractionated laser. There is also a large group of nanotechnology-related approaches with ALA being delivered using liposomes/ethosomes, ALA dendrimers, niosomes, mesoporous silica nanoparticles, conjugated gold nanoparticles, polymer nanoparticles, fullerene nanoparticles, and carbon nanotubes. In the second group, we can find the use of cellular differentiating agents, the use of iron chelators, and the effect of increasing the temperature. In the third group, we find methods designed to reduce pain as well as improve efficiency including fractionated light, daylight PDT, and wearable light sources for ambulatory PDT. This active area of research is expected to continue to provide a range of intriguing possibilities.

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Fractional Carbon Dioxide Laser Improves Nodular Basal Cell Carcinoma Treatment with Photodynamic Therapy with Methyl 5-Aminolevulinate

Abstract: Fractional laser pretreatment increases the fluorescence and clinical effectiveness of ALA-PDT for the treatment of nBCC.

Cited by 58 publications

References 27 publications

Laser-assisted drug delivery in dermatology: from animal models to clinical practice

Laser-assisted drug delivery in dermatology: from animal models to clinical practice

Ablative fractional laser enhances MAL-induced PpIX accumulation: Impact of laser channel density, incubation time and drug concentration

Current Advances in 5-Aminolevulinic Acid Mediated Photodynamic Therapy

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