Evaluation of vulvar leukoplakia photodynamic therapy efficiency by fluorescent diagnostics method with local «Alasens®» photosensitizer application

Sharova, Alina S.; Farrakhova, Dina; Slovokhodov, E. K.; Аракелов, С Э; Зыков, А Е; Sarantsev, Andrey; Linkov, Kirill G.; Loschenov, Victor B.

doi:10.1016/j.pdpdt.2019.05.018

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…To study the intensity of PpIX fluorescence in the tissues of the cervix and vulva, the application method of PS administration was used, which is presented in [17]. To prepare the PS solutions at a concentration of 10 mg ml −1 , crystalline ALA and HAL powders were dissolved in water with a temperature of 25 • C and a volume of 3 ml.…”

Section: Methodsmentioning

confidence: 99%

Comparative investigation of 5-aminolevulinic acid and hexyl aminolevulinate-mediated photodynamic diagnostics and therapy of cervical dysplasia and vulvar leukoplakia

Efendiev¹,

Alekseeva²,

Bikmukhametova³

et al. 2021

Laser Phys. Lett.

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This study aims to conduct a comparative analysis of aminolevulinic acid and its hexyl aminolevulinate (HAL) for photodynamic diagnostics and therapy of cervical dysplasia and vulvar leukoplakia in continuous and pulsed laser irradiation mode. The fluorescence intensity of protoporphyrin IX (PpIX) in the cervix epithelium was five times higher after the application of HAL compared with the application of aminolevulinic acid. Increased intensity of fluorescence of PpIX in vulvar tissues complicated by leukoplakia was not observed with 5-aminolevulinic acid and its HAL. Intraepithelial changes in patients with cervical dysplasia were absent after photodynamic therapy (PDT) in continuous irradiation mode. Repeated PDT was prescribed to several patients with vulvar leukoplakia after pulsed light irradiation. Pulse irradiation made it possible to avoid the use of various types of anesthesia in patients. In the regime of continuous irradiation, pain sensations of varying degrees from a burning sensation to sharp pains were observed in patients in the zone of photodynamic exposure. The results presented in this paper will help to optimize the PDT process of cervical dysplasia and leukoplakia using 5-aminolevulinic acid or HAL.

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Section: Methodsmentioning

confidence: 99%

Comparative investigation of 5-aminolevulinic acid and hexyl aminolevulinate-mediated photodynamic diagnostics and therapy of cervical dysplasia and vulvar leukoplakia

Efendiev¹,

Alekseeva²,

Bikmukhametova³

et al. 2021

Laser Phys. Lett.

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“…In some cases such as atypical features, uncertainty of diagnosis, concern for malignancy, or in failed response to treatment, biopsy is mandatory. The gold standard to differentiate these conditions is histological -biopsy [22,27]. Because biopsy is the only way to exclude SCC of the vulva and vulvar intraepithelial neoplasia, it is necessary in our opinion.…”

Section: Diagnosismentioning

confidence: 99%

“…They relieve the symptoms in nearly all patients; in about 70% of the cases, symptoms disappear completely, and in 20% complete recovery of the skin is observed [29]. The British Association of Dermatologists guidelines advocate their use and propose a detailed dosing regimen [27]. The recommendations for newly diagnosed cases are: application of clobetasol propionate 0.05% ointment once daily at night time for the duration of 4 weeks, followed by application on alternate nights for 4 weeks, and then twice weekly for a further 4 weeks.…”

Section: Treatmentmentioning

confidence: 99%

Vulvar leukoplakia: therapeutic options

Yordanov¹,

Tantchev²,

Kostov³

et al. 2020

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Vulvar leukoplakia is not a histological diagnosis and involves several diseases. Most commonly, these are vulvar lichen sclerosus and squamous cell hyperplasia of the vulva. These two conditions have similar aetiology, clinical presentation and treatment but different histopathological changes. They both lead to significant impairment of quality of life, risk of malignancy, as well as recurrence after treatment. Treatment of these conditions includes topical corticosteroids as a first-line therapy, but they have their side effects and not all patients are receptive to this therapy. This requires the use of alternative therapeutic options such as topical calcineurin inhibitors, topical and systemic retinoids, other steroid creams, various destructive techniques and, as a last resort, surgical removal of affected tissues. Surgical treatment should be avoided, despite the malignant potential, because of recurrence risk in both diseases New therapeutic approaches are coming into effect in gynaecological practice due to potential risks of the above-mentioned methods. Platelet-rich plasma therapy, ablative and non-ablative laser treatment, and new topical medicines, are some of the new options applied to improve the efficacy of treatment avoiding the side effects of conventional medications. A number of them are still in their initial phase of application and time will tell their effectiveness.

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