MAL Daylight Photodynamic Therapy for Actinic Keratosis: Clinical and Imaging Evaluation by 3D Camera

Abstract

Non-melanoma skin cancer is the most common skin cancer with an incidence that varies widely worldwide. Among them, actinic keratosis (AK), considered by some authors as in situ squamous cell carcinoma (SCC), are the most common and reflect an abnormal multistep skin cell development due to the chronic ultraviolet (UV) light exposure. No ideal treatment exists, but the potential risk of their development in a more invasive form requires prompt treatment. As patients usually present with multiple AK on fields of actinic damage, there is a need for effective, safe, simple and short treatments which allow the treatment of large areas. To achieve this, daylight photodynamic therapy (DL-PDT) is an innovative treatment for multiple mild actinic keratosis, well tolerated by patients. Patients allocated to the PDT unit, affected by multiple mild−moderate and severe actinic keratosis on sun-exposed areas treated with DL-PDT, were clinically evaluated at baseline and every three months with an Antera 3D, Miravex© camera. Clinical and 3D images were performed at each clinical check almost every three months. In this retrospective study, 331 patients (56.7% male, 43.3% female) were treated with DL-PDT. We observed a full clearance in more than two-thirds of patients with one or two treatments. Different responses depend on the number of lesions and on their severity; for patients with 1–3 lesions and with grade I or II AK, a full clearance was reached in 85% of cases with a maximum of two treatments. DL-PDT in general improved skin tone and erased sun damage. Evaluating each Antera 3D images, hemoglobin concentration and pigmentation, a skin color and tone improvement in 310 patients was observed. DL-PDT appears as a promising, effective, simple, tolerable and practical treatment for actinic damage associated with AK, and even treatment of large areas can be with little or no pain. The 3D imaging allowed for quantifying in real time the aesthetic benefits of DL-PDT’s increasing compliance.

Picosecond laser treatment of atrophic and hypertrophic surgical scars: In vivo monitoring of results by means of 3D imaging and reflectance confocal microscopy

“…The standard method for monitoring skin response to treatments has been based on skin biopsy. However, advances in noninvasive skin imaging techniques such as 3D imaging and RCM have enabled the in vivo evaluation of variations occurring in the same point of skin, analyzing different parameters such as mean texture and different layers, including epidermis, DEJ, and dermis …”

“…We performed an in vivo optical skin imaging enabling optical evaluation of the optical skin structure, in order to monitor effects of treatment by means of a device called Antera 3D (Antera 3D; Miravex Limited). This device exploits multi‐directional illumination and computer‐aided reconstruction of skin surfaces and evaluates distribution and concentration of melanin and hemoglobin …”

“…The aim of this study is to apply PSL system to atrophic and hypertrophic surgical scars and to report in vivo architecture of scars and variations occurring before and after treatment. In this study, 3D optical tool assessment of skin surfaces, hemoglobin and melanin concentration and distribution, as well as reflectance confocal microscopy (RCM), enabling evaluation of the skin at a quasi ‐histological resolution and providing in vivo information about epidermal, dermo‐epidermal junction (DEJ), and dermal features, were employed to explore the effects of PSL.…”

AK-DL: A Shallow Neural Network Model for Diagnosing Actinic Keratosis with Better Performance than Deep Neural Networks

“…Additionally, employing the Markov chain model [38] or traditional statistical methods based on the high-throughput sequencing data of human skin microbial community is also one of the methods for diagnosing AK, but the cost is obviously much higher. Moreover, several other technologies, including Antera 3D technology [39,40], in-vivo or ex-vivo reflectance confocal microscopy (RCM) [41,42], and dermoscopy analysis [43], have been employed for the diagnosis of skin diseases and monitor them after treatment. The detection effect of these abovementioned methods have been verified in actual application, which are considered relatively effective, but their equipment cost and operation complexity are higher than the model proposed in our study.…”

Sequential methyl-aminolevulinate daylight photodynamic therapy and diclofenac plus hyaluronic acid gel treatment for multiple actinic keratosis evaluation

“…Actinic keratosis (AK) is a chronic‐relapsing skin lesion, considered as an early stage of invasive squamous cell carcinoma (iSCC) on chronically sun damaged skin (Cantisani et al ; Cantisani et al ). AK places a significant burden on health care system (Cantisani, Paolino, Bottoni, & Calvieri, ; Tolley, Argenziano, Calzavara‐Pinton, Larsson, & Ryttig, ).…”