Photodynamic therapy for skin rejuvenation: review and summary of the literature – results of a consensus conference of an expert group for aesthetic photodynamic therapy

Karrer, Sigrid; Kohl, Elisabeth; Feise, Konstantin; Hiepe-Wegener, Dagmar; Lischner, Stephan; Philipp‐Dormston, Wolfgang G.; Prager, Welf; Walker, Torsten; Szeimies, Rolf‐Markus

doi:10.1111/j.1610-0387.2012.08046.x

Cited by 41 publications

(39 citation statements)

References 33 publications

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“…The rejuvenating effects of PDT on photoaged skin have been well‐documented in several preclinical and clinical trials, and have been recently reviewed by an expert group for aesthetic PDT . Besides the clearance and prevention of AK, an improved skin texture (tactile roughness), pale skin, wrinkles, mottled pigmentation, dyspigmentation (including solar lentigines), facial erythema and elastosis were demonstrated in most studies after c‐PDT.…”

Section: Resultsmentioning

confidence: 99%

“…The rejuvenating effects of PDT on photoaged skin have been well-documented in several preclinical and clinical trials, 11,21,[31][32][33][34][45][46][47] and have been recently reviewed by an expert group for aesthetic PDT. 48 Besides the clearance and prevention 24 of AK, an improved skin texture (tactile roughness), pale skin, wrinkles, Advantages of DL-PDT for the treatment of actinic field damage Based on the concept of actinic field damage, DL-PDT appears to be the ideal option for the unmet need of a convenient yet effective treatment. As for c-PDT, it is characterized by a combination of selective keratinocyte uptake and cytotoxicity as well as indirect cytokine-mediated dermal effect, as illustrated in Fig.…”

Section: C-pdt In Actinic Field Damagementioning

confidence: 99%

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Daylight photodynamic therapy with MAL cream for large‐scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group

Philipp‐Dormston¹,

Sanclemente

Torezan

et al. 2015

Acad Dermatol Venereol

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Conventional PDT (c-PDT) is a widely used and approved non-invasive treatment for actinic keratosis (AK). Recent clinical, histological and immunohistochemical observations have shown that c-PDT with methyl aminolevulinate (MAL) may also partially reverse the signs of photodamage. However, pain and the need for special light source equipment are limiting factors for its use, especially in the treatment of large areas. More recently, daylight PDT (DL-PDT) has been shown to be similar to c-PDT in the treatment of AK, nearly painless and more convenient to perform. To establish consensus on recommendations for the use of MAL DL-PDT in patients with large-scale photodamaged skin. The expert group was comprised of eight dermatologists. Consensus was developed based on the personal experience of the experts in c-PDT and DL-PDT, and results of an extensive literature review. MAL DL-PDT for large areas of photodamaged skin was evaluated and recommendations based on broad clinical experience were provided. As supported by evidence-based data from multicentre studies conducted in Australia and Europe, the authors defined the concept of 'actinic field damage' which refers to photodamage associated with actinic epidermal dysplasia, and provide comprehensive guidelines for the optimal use of DL-PDT in the treatment of actinic field damage. The authors concluded that MAL DL-PDT has a similar efficacy to c-PDT at 3-month (lesion complete response rate of 89% vs. 93% in the Australian study and 70% vs. 74% in the European study (95% C.I. = [-6.8;-0.3] and [-9.5;2.4] respectively) and 6-month follow-ups (97% maintenance of complete lesion response) in the treatment of AKs. The authors agree that DL-PDT is not only efficacious but also nearly pain-free and easy to perform, and therefore results in high patient acceptance especially for the treatment of areas of actinic field damage.

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Section: Resultsmentioning

confidence: 99%

Section: C-pdt In Actinic Field Damagementioning

confidence: 99%

Daylight photodynamic therapy with MAL cream for large‐scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group

Philipp‐Dormston¹,

Sanclemente

Torezan

et al. 2015

Acad Dermatol Venereol

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“…The inflammatory response associated with PDT is often accompanied by the dermal formation of collagen which leads to an improved skin appearance in the treated area. This has been reported by several authors and becomes especially evident when performing field-directed PDT [82][83][84][85]. In the recent pivotal study evaluating BF-200 ALA in field-directed PDT, the cosmetic outcome was diligently studied and reported on a Phase III level [80].…”

Section: Cosmetic Outcomementioning

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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“…10,11 A versatilidade desta técnica é potenciada pela sua eficá-cia, cosmeticidade e baixo risco de efeitos adversos. 10,11 Infelizmente, a dor resultante deste procedimento é extremamente frequente (92% -97% 12 sendo grave em 16% 13 ), continuando a ser este o fator que mais limita o seu uso terapêutico. 14,15 A identificação dos doentes com risco de desenvolver dor intensa no decurso da PDT possibilitaria o emprego de estratégias analgésicas pré-procedimento.…”

Section: Terapêutica Fotodinâmicaunclassified

Abordagem da Dor em Dermatologia (Parte II)

Duarte

Roberto

Cruz

et al. 2018

SPDV

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RESUMO -A dor é um sintoma universal em Medicina; e na Dermatovenereologia é transversal ao seu domínio médico e cirúrgi-co. No domínio cirúrgico da especialidade temos a dor aguda peri-operatória, provavelmente mais frequente do que o esperado e cujo tratamento insuficiente implica morbilidade aguda e até potencialmente a longo prazo, dado o risco de cronificação. A dor crónica está associada a várias doenças cutâneas e é muitas vezes causa major de sofrimento para os doentes, dada a sua abordagem ser complexa, desafiante e por vezes infrutífera, agravada pela pouca evidência sobre como tratar apropriadamente o doente dermatológico com dor crónica. Este artigo é a segunda e última parte de uma revisão cujo objetivo é discutir os princípios gerais do tratamento da dor aguda peri--operatória e crónica no contexto da especialidade. Neste segundo capítulo será abordada a dor relacionada com procedimentos terapêuticos específicos. Por último, será discutida a dor crónica associada a entidades dermatológicas com quadros álgicos significativos. PALAVRAS-CHAVE - INTRODUÇÃOA dor é considerada o quinto sinal vital e o seu controlo é um indicador de qualidade dos serviços de saúde. Na primeira parte desta revisão, foi demonstrada a repercussão que a dor não controlada pode ter nas múltiplas esferas do domínio socioeconómico e familiar: sofrimento para os doentes e cuidadores, absentismo profissional, isolamento social e consumo significativo dos recursos de saúde. Observámos também que na Dermatologia e Venereologia, enquanto especialidade médico-cirúrgica, a dor não controlada é um sintoma frequentemente presente, quer por consequência de procedimentos cirúrgicos, quer devido a entidades clínicas com quadros fisiopatológicos complexos (como a úlcera de perna), e ao qual está associada uma perda major de qualidade de vida.Torna-se assim evidente a importância do tratamento eficaz da dor no doente dermatológico. Contudo, o controlo da dor, principalmente da dor crónica, continua a ser um desafio, havendo necessidade de delinear estratégias eficazes. A segunda parte deste artigo tem como objetivo colmatar esta necessidade, ao abordar o tratamento da dor aguda em procedimentos dermatológicos específicos e o tratamento da dor crónica associada a algumas entidades clínicas de gestão difícil.

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Photodynamic therapy for skin rejuvenation: review and summary of the literature – results of a consensus conference of an expert group for aesthetic photodynamic therapy

Cited by 41 publications

References 33 publications

Daylight photodynamic therapy with MAL cream for large‐scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group

Daylight photodynamic therapy with MAL cream for large‐scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group

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

Abordagem da Dor em Dermatologia (Parte II)

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