Imiquimod and Photodynamic Therapy Are Useful in the Treatment of Porokeratosis in Children with Bone Marrow Transplantation

Abstract

Porokeratosis is an uncommon disorder that affects keratinization. Immunosuppression may favor the development of porokeratotic lesions. Patients who receive allogenic transplants represent a therapeutic challenge to dermatologists. We report two cases of porokeratosis in children with bone marrow transplant and their excellent response to imiquimod and photodynamic therapy.

Photodynamic therapy inhibit Fibroblast Growth Factor-10 induced keratinocyte differentiation and proliferation through ROS in Fibroblast Growth Factor Receptor-2b pathway

“…found that psoriatic lesions showed some evident clinical improvement during the ALA-PDT treatment period which was reflected in a statistically significant decrease in the clinical plaque severity score 11 . Several cases of classic porokeratosis such as porokeratosis of Mibelli treated with PDT successfully revealed 9 10 . Above clinical results indicate ALA-PDT regulates keratinization, however still need specific models to confirm it.…”

“…The follicular obstruction in non-inflammatory acne lesions was believed to be reduced by ALA-PDT through changing keratinocyte shedding and hyperkeratosis 2 . Recently, ALA-PDT was also shown successfully treated abnormal keratinization related dermatoses such as psoriasis and porokeratosis 9 10 11 . These clinical results suggest ALA-PDT may regulate in abnormal keratinocyte differentiation and proliferation.…”

A 12‐Year‐Old Boy with Multiple Scaly Papules

“…Treatment is challenging, but options include cryotherapy, carbon dioxide laser, keratolytics, 5‐flurouracil cream, vitamin D analogs, and oral retinoids. A case report recently noted good efficacy with imiquimod or photodynamic therapy in children after bone marrow transplantation . Our patient opted to pursue no treatment since the lesions were asymptomatic and he disliked applying creams.…”

Photodynamic therapy for dermatologic conditions in the pediatric population: a literature review

“…Finally, Gracia‐Cazaña et al . reported the successful use of MAL‐PDT to treat porokeratoses on the neck and leg of a 12‐year‐old boy, previously diagnosed with acute B‐ALL which necessitated a bone marrow transplant. Prior to PDT, lesions failed to respond to calcipotriol, 5‐FU, and 5% imiquimod.…”

“…While recurrence was observed 11 months later, the initial cosmetic response was excellent, resulting in near-complete resolution. Finally, Gracia-Cazaña et al (46) reported the successful use of MAL-PDT to treat porokeratoses on the neck and leg of a 12-year-old boy, previously diagnosed with acute B-ALL which necessitated a bone marrow transplant. Prior to PDT, lesions failed to respond to calcipotriol, 5-FU, and 5% imiquimod.…”