Introduction. Actinic keratosis is a chronic disease that often requires many treatment cycles. The choice of a treatment method depends on the thickness and number of lesions as well as their extent. An efficient method of treatment, especially in the case of superficial and moderately thick lesions, is photodynamic therapy. Objective. Assessment of the photodynamic therapy with the use of a superluminescent light-emitting diode lamp after previous application of 5-aminolevulinic acid based on the observations of selected cases of patients with actinic keratosis. Material and methods. The study included patients diagnosed with actinic keratosis. After debridement of scales and crusts from the affected skin area 16% 5-aminolevulinic acid cream was applied. The irradiation was performed with the use of the superluminescent light-emitting diode matrix illuminator Medlight that sent out pulsed red light. The clinical evaluation was carried out before, immediately after the procedure as well as after 1 and 3 weeks. Results. In one case, after many years of ineffective treatment with a cryosurgery, the treatment with application of superluminescent light-emitting diode therapy lead to disease remission. In the second case early therapy with the superluminescent light-emitting diode lamp lead to complete resolution of lesions. In the case of a patient with disseminated actinic keratosis, lesion-directed therapy was possible. Conclusions. Observation results indicate a beneficial effect of superluminescent light-emitting diodes and no recurrence of actinic keratosis lesions in 3 months after the procedure.

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Photodynamic therapy (PDT) is safe and effective in the treatment of patients with actinic keratosis (AK). The aim of the study was to assess the efficacy, tolerability and cosmetic outcome of topical PDT in the treatment of AKs with three forms of photosensitizers: 5-Aminolevulinic acid hydrochloride (ALA-HCl), 5-Aminolevulinate methyl ester hydrochloride (MAL-HCl) and 5-Aminolevulinate phosphate (ALA-P). The formulations were applied onto selected scalp/face areas. Fluorescence was assessed with a FotoFinder Dermoscope 800 attachment. Skin areas were irradiated with Red Beam Pro+, Model APRO (MedLight GmbH, Herford, Germany). Applied treatments were assessed during the PDT as well as 7 days and 12 weeks after its completion. Ninety-four percent of patients rated obtained cosmetic effect excellent. The efficacy of applied PSs did not differ significantly. However, pain intensity during the PDT procedure was significantly lower in the area treated with ALA-P (5.8 on average) in comparison to the areas treated with ALA-HCl or MAL-HCl (7.0 on average on 0–10 scale). Obtained results show that ALA-P may undergo more selective accumulation than ALA-HCl and MAL-HCl. Our promising results suggest that PDT with the use of ALA-P in AK treatment may be an advantageous alternative to the already used ALA-HCl and MAL-HCl.

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Introduction. Over the last few decades, an increasing proportion of skin diseases has been treated in non-dermatology wards. Objective. Identification of the 30 most common dermatologic conditions subject to hospitalization reported by dermatologists and non--dermatologists in Poland. Material and methods. A quantitative analysis of clinical data of the Polish National Health Fund for the year 2018 has been performed. Results. Over 245,000 hospitalizations with regard to skin-related problems were identified, including 99,500 one-day hospitalizations. Seventy-six percent of all hospitalizations were reported in non-dermatology departments, 27% of which required a surgical procedure. Dermal infections (L03, L02, L05, A46, B08, B02) and skin tumors (D21, D23, D17, C44) were the most common reasons for hospitalization, accounting for over 30% of all hospital stays, frequently in general surgical wards. Non-dermatology wards (mostly surgical and pediatric) reported a significant proportion of emergency admissions due to cellulitis, urticaria, lower extremity ulcers, erysipelas, pressure ulcer, viral infections, and thermal and chemical burns of the trunk. Systemic connective tissue diseases were mostly treated by rheumatologists. The diseases most frequently treated by dermatologists were psoriasis (33.5% of all admissions), dermatitis (23.8%), malignant skin neoplasms (12.5%), non-malignant skin neoplasms (10.5%) and lower extremity ulcers (L97) (10.5%). Patients in dermatology wards were older than those in non-dermatology ones (52.3 years versus 42.8 years respectively, p < 0.001). The average length of stay (ALOS) was 5.1 days, but patients in dermatology wards stayed longer (p < 0.001). Conclusions. A higher number of dermatosurgeons and dermatologists as hospital consultants might help ensure better use of inpatient facilities.