Methylaminolaevulinic Acid Photodynamic Therapy in the Treatment of Erythroplasia of Queyrat

Abstract

Background: Erythroplasia of Queyrat (EQ) is an intra-epithelial carcinoma of the penis. Progression to invasive carcinoma may occur. Its cause is unknown but some evidence suggests infection with human papillomavirus in the pathogenesis of EQ; however, recent data do not confirm this. Therapy is difficult and associated with important recurrence rates. Photodynamic therapy (PDT) employs a photosensitizer excited by visible light. The resulting photodynamic reaction selectively destroys atypical cells. Only few reports exist on the use of topical PDT in the treatment of EQ. Objective: We report 11 cases of EQ treated by topical methylaminolaevulinic acid (MAL) PDT. Results: Out of 11 male patients withEQ treated by topical MAL-PDT, 3 achieved complete remission sustained for 24 and 51 months and 4 a partial remission sustained for 2–45 months with a follow-up period of 4–45 months (1 patient lost to follow-up); surprisingly, 2 of the 4 patients with partial remission presented a complete remission after 20 and 45 months of follow-up, respectively, without further therapy. Four patients showed progression of the disease. Conclusion: Whereas topical MAL-PDT offers the advantages of tumour specificity, preservation of function and a good cosmetic result, side effects may cause treatment discontinuation in some cases. Treatment of EQ with PDT may represent a valuable option in selected cases, but our data do not allow considering it as a first-line therapeutic option.

BritishAssociation ofDermatologists' guidelines for the management of squamous cell carcinomain situ(Bowen's disease) 2014

“…160 A poorer response was noted following MAL-PDT in a series of 11 patients, with only six requiring no further treatment. 161 In a study using ALA-PDT and MAL-PDT in 10 patients with PIN, clearance was achieved in seven patients, but with recurrence in four. There was sustained clearance in the remaining patients over 46 months, including clearance of human HPV DNA.…”

Experience in the use of photodynamic therapy with methyl aminolevulinic acid in patients with erythroplasia of Queyrat

“…Опубликованы материалы по успешному использованию фотодинамической те-рапии с использованием топических фотосенсиби-лизаторов, в частности метиламинолевулиновой кис-лоты (МАЛК) [6,[9][10][11].…”

“…В результате происходит селективное раз-рушение патологически измененных клеток при максимальном сохранении окружающих здоровых. Цитотоксический эффект ФДТ зависит от концен-трации ФС и глубины проникновения света в ткани очага [9,10].…”

Optical Coherence Tomography Imaging of Erythroplasia of Queyrat and Treatment with Imiquimod 5% Cream: A Case Report

“…It is often associated with human papillomavirus (HPV) type 16 infection, and progression to invasive SCC is estimated to occur in one third of patients [2]. Current treatments for EQ range from non-invasive options such as laser ablation, photodynamic therapy and cryosurgery to invasive options such as partial or total penectomy [3,4]. Another potential topical non-invasive treatment for EQ is imiquimod 5% (Aldara®), a novel immunomodulator with antitumour and antiviral properties, which has been shown to be effective in treating intra-epithelial carcinomas, such as actinic keratosis and superficial basal cell carcinomas, as well as external perianal and genital warts.…”