Topical Methyl Aminolevulinate Photodynamic Therapy Using Red Light-Emitting Diode Light for Multiple Actinic Keratoses

Szeimies, R.-M.; Matheson, Robert; Davis, Steven A.; Bhatia, Ashish C.; Frambach, Yvonne; Klövekorn, Winfried; Fesq, Heike; Berking, Carola; Reifenberger, Julia; Thaçi, Diamant

doi:10.1111/j.1524-4725.2009.01096.x

Cited by 80 publications

(66 citation statements)

References 13 publications

(69 reference statements)

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“…Red light illumination allows treatment of skin lesions to a depth of 2 mm [8,9,10]. AK lesions are also commonly treated with blue light (405 nm), which penetrates efficiently to 200-300 μm in the skin [4,11,12,13,14]. …”

Section: Introductionmentioning

confidence: 99%

Correlation between Protoporphyrin IX Fluorescence Intensity, Photobleaching, Pain and Clinical Outcome of Actinic Keratosis Treated by Photodynamic Therapy

Piffaretti

Zellweger

Kasraee³

et al. 2013

Dermatology

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Background: Photodynamic therapy (PDT) with Metvix® is a good therapeutic option to treat actinic keratosis, but it presents drawbacks (pain, lesion recurrences, heterogeneous outcome), emphasizing the possible need to individualize treatment. Objective: We assessed whether PDT clinical outcome and pain during treatment were correlated with protoporphyrin IX fluorescence intensity and photobleaching. Methods: 25 patients were treated by Metvix PDT. The outcome was evaluated after 1.3 (±0.4), 7.6 (±1.8), 13.2 (±1.2) and 33.6 (±3.0) months. After administration of Metvix, red light (632 ± 10 nm) was delivered with a light-emitting diode panel device. The outcome was assessed on a cosmetoclinical scale. Results: All patients who showed a fluorescence level before PDT treatment above a certain threshold had a complete recovery at 33.6 (±3.0) months. Conclusion: Our approach could be used to individualize PDT treatment based on the pretreatment fluorescence level, and to predict its long-term outcome.

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Section: Introductionmentioning

confidence: 99%

Correlation between Protoporphyrin IX Fluorescence Intensity, Photobleaching, Pain and Clinical Outcome of Actinic Keratosis Treated by Photodynamic Therapy

Piffaretti

Zellweger

Kasraee³

et al. 2013

Dermatology

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“…Furthermore, patients with large, high-grade, thickened, or hyperkeratotic AKs are excluded from most clinical trials, 31,35,36 although they may be included in studies on photodynamic therapy (PDT), in which curettage of hypertrophic AKs is allowed. [37][38][39] For these reasons, it may not be possible to generalize findings across reports.…”

Section: Overview Of the Clinical Literature On Aksmentioning

confidence: 99%

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

et al. 2015

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Background Actinic keratosis (AK) and cheilitis (AC) are lesions that develop on photodamaged skin and may progress to form invasive squamous cell carcinomas (SCCs). Objective To provide guidance to Canadian health care practitioners regarding management of AKs and ACs. Methods Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines). Results Treatment of AKs allows for secondary prevention of skin cancer in sun-damaged skin. Because it is impossible to predict whether a given AK will regress, persist, or progress, AKs should ideally be treated. This chapter discusses options for the management of AKs and ACs. Conclusions Treatment options include surgical removal, topical treatment, and photodynamic therapy. Combined modalities may be used in case of inadequate response. AKs are particularly common following the longterm immunosuppression in organ transplant patients, who should be monitored frequently to identify emerging lesions that require surgery.

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“…1,13,14 Agentes Fotossensibilizantes Agentes tópicos 5-ALA e MAL ALA é um agente hidrofílico sendo captado pelas células, principalmente, através de transporte ativo, como Na+/Cl-dependente de beta aminoácidos como glicina e ácido gama aminobutírico (GABA) carregadores. 15 Esses sistemas requerem energia, dependem de pH e temperatura, são lentos e saturáveis e estão um pouco mais acelerados em células tumorais.…”

Section: Históricounclassified

“…Nas últimas décadas, a TFD progrediu de um recurso terapêutico experimental para primeira opção no tratamento de lesões como queratoses actínicas (QA) e outras lesões superficiais extensas como carcinoma basocelular superficial (CBC) e doença de Bowen (DB). [1][2][3] Hoje em dia, vemos um crescimento enorme da TFD e suas aplicações. Por um lado parece fascinante, por outro, até meio controverso através da combinação de várias drogas, protocolos, fontes de luz, novas indicações, que podem desorientar o profissional médico que esteja iniciando sua experiência com TFD.…”

Section: Introductionunclassified

Terapia fotodinâmica em dermatologia: princípios básicos e aplicações

Torezan

Niwa

Neto³

2009

An. Bras. Dermatol.

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Resumo:A terapia fotodinâmica envolve a administração de uma droga fotossensibilizante e sua ativação subsequente pela luz de comprimento de onda correspondente ao espectro de absorção do fotossensibilizador. Atualmente, a terapia fotodinâmica tópica é aprovada para o tratamento de condições oncológicas cutâneas como queratoses actínicas, doença de Bowen e carcinoma basocelular superficial em diversos países do mundo. Estudos multicêntricos controlados e randomizados demonstram a alta eficácia e resultado cosmético final superior dessa modalidade terapêutica em relação aos tratamentos convencionais. Para condições cutâneas não oncológicas, como acne vulgar, verrugas virais e esclerodermia localizada, há também relatos e série de casos confirmando o potencial terapêutico da terapia fotodinâmica. O desenvolvimento de fotossensibilizantes tópicos, ácido 5-aminolevulínico (ALA) ou seu metiléster (MAL), frente aos derivados da hematoporfirina de aplicação sistêmica, permitiu um grande avanço na popularidade da TFD na dermatologia, uma vez que tanto ALA quanto MAL tópicos não induzem mais fotossensibilidade generalizada prolongada. A produção de intermediários reativos de oxigênio, como oxigênio singlet, depende da concentração, da localização do fotossensibilizante no tecido alvo, assim como da dose de luz utilizada. Tanto as lâmpadas de amplo espectro quanto os LEDs (do inglês light emitting diodes) constituem fontes de luz adequadas para que os efeitos citotóxicos da terapia fotodinâmica resultem na destruição do tumor ou seus efeitos imunomodulatórios atuem melhorando as condições inflamatórias cutâneas. Palavras-chave: Carcinoma basocelular; Carcinoma in situ; Fotoquimioterapia Abstract: Photodynamic therapy involves the administration of a photosensitizing drug and its subsequent activation by light at wavelengths matching the absorption spectrum of the photosensitizer. Currently, topical photodynamic therapy has received approval for the treatment of cutaneous oncologic conditions such as actinic keratoses, Bowen's disease and superficial basal cell carcinoma in many countries in the world. Multicenter randomized controlled studies have demonstrated high efficacy and superior cosmetic outcome over standard therapies. For many non-oncologic dermatological diseases such as acne vulgaris, viral warts and localized scleroderma, case reports and small series have confirmed the potential of photodynamic therapy. After the development of topical photosensitizers 5-aminolevulinic acid (ALA) or its methyl ester (MAL), photodynamic therapy has gained worldwide popularity in dermatology, as these drugs do not induce prolonged phototoxicity as the systemic photosensitizing hematoporphyrin derivatives do. The production of reactive oxygen intermediates such as singlet oxygen depends on the concentration and localization of the photosensitizer in the diseased tissue as well as the applied light dose. Either incoherent lamps or LED arrays are suitable for the cytotoxic effects resulting in tumor destruction or immunomodulator...

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Topical Methyl Aminolevulinate Photodynamic Therapy Using Red Light-Emitting Diode Light for Multiple Actinic Keratoses

Abstract: Topical MAL PDT using a LED is an effective treatment for multiple AKs.

Cited by 80 publications

References 13 publications

Correlation between Protoporphyrin IX Fluorescence Intensity, Photobleaching, Pain and Clinical Outcome of Actinic Keratosis Treated by Photodynamic Therapy

Correlation between Protoporphyrin IX Fluorescence Intensity, Photobleaching, Pain and Clinical Outcome of Actinic Keratosis Treated by Photodynamic Therapy

Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

Terapia fotodinâmica em dermatologia: princípios básicos e aplicações

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