Pseudoepitheliomatous Hyperplasia Treated by Photodynamic Therapy with Variable Irradiation Dose and Concentration of Photosensitizer

Abstract

Objective: The aim of this study was to test the effectiveness of photodynamic therapy (PDT) in treating pseudoepitheliomatous hyperplasia (PEH) after skin wounding. Background Data: PEH is a difficult-to-treat extreme-degree acanthosis characterized by proliferation of the epithelium. Topical PDT offers an effective and non-invasive treatment for intraepithelial neoplasia and inflammatory dermatosis. These disorders and PEH show the same histological features: epidermal hyperplasia. To our knowledge, there have been no clinical trials published about therapeutic responses of PDT for PEH. Materials and Methods: After application of 10-30% methyl aminolaevulinate (MAL) emulsion, each lesion was irradiated with 633-nm red light at a total dose of 113-339 J/ cm 2 . Therapeutic response was assessed by clinical examination at 3 months. Results: Only 4 of 16 lesions clinically showed a minimal response. No response was observed in 12 of the 16 lesions, either with different cumulative doses or different concentrations of MAL. Conclusion: PEH after skin wounding responds poorly to the topical MAL-PDT. Besides removal of underlying diseases, surgical excision is still the recommended first option.

Pseudoepitheliomatous Hyperplasia of the Larynx Requiring Total Laryngectomy

“…The benign nature of PEH means that most cases are resolved by means of excision biopsy, although grafts or flaps are occasionally needed to reconstruct major tissue defects [ 3 , 5 , 6 ]. On occasions, due to the different underlying causes, a biopsy is not sufficient, and etiological treatment is required, depending on each of the pathologies mentioned in the introduction [ 1 – 3 ].…”

“…Having ruled out malignancy, we performed conservative treatment over 20 months, using antibiotics and local excision of lesions by means of transoral laser surgery. The literature refers to therapeutic alternatives, including diode laser, KTP laser, photodynamic therapy and microdebriders [ 5 , 14 , 15 ].…”

“…PEH may occur in response to a multitude of stimuli, including bacterial, viral, or fungal infection [ 1 , 2 ]. Correct diagnosis and treatment may be obtained by means of extensive, deep excision biopsy [ 3 – 5 ]. At times, due to the similarity with SCC, multiple biopsies are required to avoid unnecessary aggressive surgery [ 4 ].…”

Non-melanoma Skin Cancer and Other Epidermal Tumors

“…(Courtesy of Dr. Luisa Motta, Salford Royal NHS Foundation Trust, Salford, UK)chromosome. It equally affects both sexes(El Safoury et al 2013;Salem et al 2013;Li et al 2011). -Clinical feature: The most common clinical features of this syndrome are also used as diagnostic criteria to establish the diagnosis…”