Daylight photodynamic therapy with methyl-aminolevulinate for the treatment of actinic cheilitis

Abstract

Actinic cheilitis (AC) is a common premalignant condition that requires an effective treatment to reduce the risk of malignant transformation. Photodynamic therapy (PDT) has been recently added to the armamentarium available for AC treatment. Daylight PDT (D-PDT) is a novel PDT modality in which the activation of the topical photosensitizer is induced by the exposure to natural daylight instead of artificial light sources without preliminary occlusion. This simplified procedure was found to be more tolerated as compared to conventional PDT. We report our preliminary experience on the use of D-PDT using methyl-aminolevulinate cream in 10 patients with refractory AC of the lower lip. Patients received two consecutive D-PDT sessions with an interval of 7-14 days. At 3 months after therapy, a complete response was observed in seven patients, with sustained results in five patients over an observational period of 6-12 months. Treatment was well tolerated.

Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta‐analysis of malignant transformation rate by subtype

“…After title/abstract screening, 4324 papers were selected for abstract evaluation. Of these, 92 studies were included in the final analysis . Fourty‐six reports were on LP, 5 on OLL, 28 on LE, 8 on OE, 4 on OSF, and 11 on PVL (all the studies taken for every subgroup sum up to a figure higher than 92 because some studies focused on more than one OPMD).…”

European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 1: treatment delivery and established indications – actinic keratoses, Bowen's disease and basal cell carcinomas

“…Two recent publications detail DL MAL‐PDT for actinic cheilitis which achieved sustained response in 5/10 patients over 6–12 months of follow‐up in a study of two treatments 7–14 days apart, whilst a 91% cure rate in 10/11 patients was achieved using repeated treatments – mean 2.8 …”

“…94 Two recent publications detail DL MAL-PDT for actinic cheilitis which achieved sustained response in 5/10 patients over 6-12 months of follow-up in a study of two treatments 7-14 days apart, whilst a 91% cure rate in 10/11 patients was achieved using repeated treatmentsmean 2.8. 95,96 Therapy guidelines identify PDT as effective both as a lesion and field-directed treatment and suggest PDT has a role where AKs are multiple/clustered, as a suitable choice for patients wishing to manage background actinic changes, and as part of maintenance treatment for low-grade AKs in sun damaged skin. 97,98 PDT remains a predominantly hospital-based therapy in most countries whilst many patients with AK are treated by primary care physicians.…”

Surgical versus non‐surgical treatment of actinic cheilitis: A systematic review and meta‐analysis

“…In four studies, the patients did not undergo previous treatment or previous treatment occurred at least 8 weeks prior to current treatment (Fai et al., ; Sotiriou et al., , ; Suárez‐Pérez et al., ). Two studies reported previous treatment but did not mention the time between previous and current treatment (Fai et al., ; Orenstein et al., ).…”

“…The studies varied in terms of the analysis of total or partial remission of the lesions. Two studies evaluated remission by clinical and histological analysis (Choi et al., ; Suárez‐Pérez et al., ), and the remaining studies only used clinical analysis (Castiñeiras et al., ; Fai et al., , ; Lima Gda et al., ; Satorres Nieto Nieto et al., ; Sotiriou et al., , ).…”