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

Kumar, Neha; Warren, Christine

doi:10.1111/phpp.12296

Cited by 14 publications

(11 citation statements)

References 49 publications

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“…Photodynamic therapy has been reported as a treatment for pediatric cases with basal cell nevus syndrome, squamous cell carcinoma in‐situ, xeroderma pigmentosum, condyloma acuminatum, plantar warts, acne vulgaris, and linear porokeratosis 16 . However, there is limited reporting and no information regarding long‐term safety of PDT in pediatrics.…”

Section: Discussionmentioning

confidence: 99%

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A case of pediatric lymphomatoid papulosis treated with photodynamic therapy and narrowband ultraviolet B

Snider

Costello

Ederaine

et al. 2020

Pediatric Dermatology

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Primary cutaneous CD30 + lymphoproliferative disorders (LPDs) are a spectrum of diseases of which lymphomatoid papulosis (LyP) is the most common. 1 Rarely, LyP can occur in children. 2 LyP is characterized by recurrent crops of papules and nodules that spontaneously resolve. 3 Half of patients experience symptoms of pain and/or pruritus. 4 The prognosis of LyP is excellent with a 10year overall survival of 92%. 5 LyP is associated with a 14%-51.7% risk of developing a second lymphoma, most commonly mycosis fungoides. 6-8 Despite its benign nature, individuals with LyP can develop disfiguring scarring and pigmentary changes which may significantly affect their quality of life. We present a case of resistant LyP with significant scarring in a pediatric patient successfully treated with photodynamic therapy (PDT) and narrowband ultraviolet B (nbUVB).

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Section: Discussionmentioning

confidence: 99%

“…However, there is limited reporting and no information regarding long‐term safety of PDT in pediatrics. The most common reported side effect is pain 16 . Pain can be controlled with cold air, reduced incubation time, and topical or intralesional lidocaine.…”

Section: Discussionmentioning

confidence: 99%

A case of pediatric lymphomatoid papulosis treated with photodynamic therapy and narrowband ultraviolet B

Snider

Costello

Ederaine

et al. 2020

Pediatric Dermatology

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“…For dermatological PDT usually a prodrug is topically applied to the skin, which is then converted by the cells, especially by neoplastic cells, into the actual photosensitizer [44,45]. One prodrug which has been extensively studied is 5-aminolevulinic acid (5-ALA), an endogenous precursor for the heme biosynthesis [46].…”

Section: Photodynamic Therapy For Actinic Keratosismentioning

confidence: 99%

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Reinhold¹

2017

Future Oncol.

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BF-200 ALA is a combination of a nanoscale-lipid vesicle formulation and the prodrug 5-aminolevulinic acid (5-ALA). The nanoemulsion stabilizes the prodrug and enhances its penetration through the stratum corneum. It has shown excellent therapeutic results in both lesion and field-directed photodynamic therapy of actinic keratosis (AK). AK is an early form of epidermal neoplasia and a precursor of invasive cutaneous squamous cell carcinoma. It is characterized by the combination of visible neoplastic lesions and surrounding tissue also harboring tumorigenic UV-induced mutations: a concept called field cancerization. A selective, field-directed treatment is ideal to meet the requirements of field change. Here, we review the clinical data on BF-200 ALA for AK along with a summary of molecular mechanisms and future perspectives. Actinic keratosis (AK), also known as solar keratosis, is caused by chronic exposure to sunlight or other ultraviolet light sources [1,2] and may progress to invasive squamous cell carcinoma (SCC) [3]. It is the most common lesion with malignant potential to arise on the skin. AK is mostly seen in Caucasians in skin areas that have extensive sun exposure throughout their lives [4]. Epidemiological data show a high occurrence rate of AK. Regions with higher ultraviolet exposure have a higher prevalence of AK. For the USA, the prevalence was estimated to range from 11 to 26%, while in Australia it ranged from 40 to 60%. In Europe, a prevalence of 15% in men and 6% in women has been documented [5]. Over the age of 70 years, 34% of men and 18% of women were found to have actinic keratotic lesions [6]. Next to fair skin type, an advanced age and lifelong sun exposure immunosuppression/-deficiency plays another important risk factor [5].Mostly, AK develops slowly and early in the disease process, they may disappear only to reappear later. Recurrence of the disease may include partial elimination of the initial lesion, subclinical lesion progression to visible status, or development of new lesions [7]. On top of this, an AK may progress to invasive SCC, the second-most common form of skin cancer [8,9]. The actual percentage of progress to invasive SCC remains unknown, and estimates vary from 5 to 20% within 10 to 25 years with reported annual transformation rates varying greatly from as low as 0.25% to as high as 16% [10]. The regression rate for a single untreated lesion is 15 to 63% after a year; recurrence rates range from 15 to 53% [11]. In general patients develop multiple AKs in one area and predicting which course each individual lesion will follow is impossible. Nonetheless, AK lesions are reliable markers for patients who are most predisposed to developing invasive SCC [4,[12][13].AK lesions typically appear in areas most frequently exposed to the sun such as the face, back of the hands, or bald scalp; 75% of lesions are found on the head, neck and forearms [14]. The lesions vary in appearance as well as size and can include erythematous scaly macules, rough pigmented patches and hyperker...

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“…ALA makes the skin sensitive for light, consequently it is frequently used for photodynamic therapy in different sorts of dermatologic pathology. In children of 5 years and older, the administration of ALA up to 354 mg, which is over 40 times higher than de 8 mg ALA that was applied on the skin in this study, did not have any side effects ( 23 ). Oral administration of 20 mg/kg ALA in infants of 1 year and older showed a transient increase of alanine aminotransferase ( 24 – 26 ).…”

Section: Discussionmentioning

confidence: 62%

“…ALA is registered for use in adults, for example for photodynamic therapy in dermatologic pathology ( 19 , 20 ) and to visualize brain tumors during fluorescence-guided surgery ( 21 , 22 ) and was not used in pediatric patients until recently. Research with cutaneous ALA administration up to 354 mg in infants of 5 years and older reported no side effects ( 23 ). Oral administration of 20 mg/kg ALA in infants of 1 year and older showed a transient increase of alanine aminotransferase ( 24 – 26 ).…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial Oxygen Monitoring During Surgical Repair of Congenital Diaphragmatic Hernia or Esophageal Atresia: A Feasibility Study

et al. 2020

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Current monitoring techniques in neonates lack sensitivity for hypoxia at cellular level. The recent introduction of the non-invasive Cellular Oxygen METabolism (COMET) monitor enables measuring in vivo mitochondrial oxygen tension (mitoPO 2 ), based on oxygen-dependent quenching of delayed fluorescence of 5-aminolevulinic acid (ALA)-enhanced protoporphyrin IX. The aim is to determine the feasibility and safety of non-invasive mitoPO 2 monitoring in surgical newborns. MitoPO 2 measurements were conducted in a tertiary pediatric center during surgical repair of congenital diaphragmatic hernia or esophageal atresia. Intraoperative mitoPO 2 monitoring was performed with a COMET monitor in 11 congenital diaphragmatic hernia and four esophageal atresia neonates with the median age at surgery being 2 days (IQR 1.25–5.75). Measurements were done at the skin and oxygen-dependent delayed fluorescence was measurable after at least 4 h application of an ALA plaster. Pathophysiological disturbances led to perturbations in mitoPO 2 and were not observed with standard monitoring modalities. The technique did not cause damage to the skin, and seemed safe in this respect in all patients, and in 12 cases intraoperative monitoring was successfully completed. Some external and potentially preventable factors—the measurement site being exposed to the disinfectant chlorohexidine, purple skin marker, or infrared light—seemed responsible for the inability to detect an adequate delayed fluorescence signal. In conclusion, this is the first study showing it is possible to measure mitoPO 2 in neonates and that the cutaneous administration of ALA to neonates in the described situation can be safely applied. Preliminary data suggests that mitoPO 2 in neonates responds to perturbations in physiological status.

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

Cited by 14 publications

References 49 publications

A case of pediatric lymphomatoid papulosis treated with photodynamic therapy and narrowband ultraviolet B

A case of pediatric lymphomatoid papulosis treated with photodynamic therapy and narrowband ultraviolet B

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Mitochondrial Oxygen Monitoring During Surgical Repair of Congenital Diaphragmatic Hernia or Esophageal Atresia: A Feasibility Study

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