Topical methyl aminolaevulinate photodynamic therapy in patients with basal cell carcinoma prone to complications and poor cosmetic outcome with conventional treatment

Horn, Michael; Wolf, Peter; Wulf, H; Warloe, Trond; Fritsch, Clemens; Rhodes, Lesley E.; Kaufmann, Roland; Rie, Menno A. de; Legat, Franz J.; Stender, Ida‐Marie; Soler, Antonio Palanca; Wennberg, Ann‐Marie; Wong, Gary; Larkö, Olle

doi:10.1111/j.1365-2133.2003.05600.x

Cited by 175 publications

(180 citation statements)

References 15 publications

Supporting

Mentioning

159

Contrasting

Unclassified

Order By: Relevance

“…77 Although MAL-PDT is noninferior to cryotherapy and surgery, the cosmetic advantage associated with MAL-PDT is of great interest for low-risk superficial BCC, because lesions are often multiple, typically affecting skin sites predisposed to dystrophic scarring (such as the trunk). [78][79][80] In randomized trials comparing different treatment modalities for BCC, a recent study demonstrated increased efficacy of imiquimod over MAL-PDT (83.4% versus 72.8%) at 12-month follow-up. This again argues for the advantage of using combination therapies with PDT, namely adding on imiquimod after treatment.…”

Section: Mal-pdt In Treatment Of Bccmentioning

confidence: 99%

Current Evidence and Applications of Photodynamic Therapy in Dermatology

2015

Journal of the Dermatology Nurses' Association

View full text Add to dashboard Cite

Abstract:In photodynamic therapy (PDT) a photosensitizer -a molecule that is activated by light -is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT.

show abstract

Section: Mal-pdt In Treatment Of Bccmentioning

confidence: 99%

Current Evidence and Applications of Photodynamic Therapy in Dermatology

2015

Journal of the Dermatology Nurses' Association

View full text Add to dashboard Cite

show abstract

“…44 Nos pacientes portadores de CBC superficial e/ou nodular de "difícil tratamento" (lesões extensas, recorrentes, locais de ruim cicatrização ou pacientes portadores de doenças sistê-micas que dificultem a cicatrização), índices de recorrência de 15% a 31% foram observados, após 36 meses de seguimento. 46,47 Para o tratamento dos CBCs com MAL, preconizam-se 2 sessões cm intervalo de 7 dias. Embora as taxas de recorrência sejam maiores, a PDT deve ser considerada uma boa opção frente a situações onde a cirurgia possa ser impeditiva.…”

Section: Aplicações Clínicas Oncológicas Em Dermatologiaunclassified

“…Após seguimento de 48 e 60 meses, a taxa de recorrência foi de 18% e 30%. 46 Sabe-se que MAL pode penetrar até 2 mm no tecido. Assim, os CBCs nodulares mais finos fora de área de risco apresentam os melhores índices de cura.…”

Section: Aplicações Clínicas Oncológicas Em Dermatologiaunclassified

Terapia fotodinâmica em dermatologia: princípios básicos e aplicações

Torezan

Niwa

Neto³

2009

An. Bras. Dermatol.

View full text Add to dashboard Cite

Resumo:A terapia fotodinâmica envolve a administração de uma droga fotossensibilizante e sua ativação subsequente pela luz de comprimento de onda correspondente ao espectro de absorção do fotossensibilizador. Atualmente, a terapia fotodinâmica tópica é aprovada para o tratamento de condições oncológicas cutâneas como queratoses actínicas, doença de Bowen e carcinoma basocelular superficial em diversos países do mundo. Estudos multicêntricos controlados e randomizados demonstram a alta eficácia e resultado cosmético final superior dessa modalidade terapêutica em relação aos tratamentos convencionais. Para condições cutâneas não oncológicas, como acne vulgar, verrugas virais e esclerodermia localizada, há também relatos e série de casos confirmando o potencial terapêutico da terapia fotodinâmica. O desenvolvimento de fotossensibilizantes tópicos, ácido 5-aminolevulínico (ALA) ou seu metiléster (MAL), frente aos derivados da hematoporfirina de aplicação sistêmica, permitiu um grande avanço na popularidade da TFD na dermatologia, uma vez que tanto ALA quanto MAL tópicos não induzem mais fotossensibilidade generalizada prolongada. A produção de intermediários reativos de oxigênio, como oxigênio singlet, depende da concentração, da localização do fotossensibilizante no tecido alvo, assim como da dose de luz utilizada. Tanto as lâmpadas de amplo espectro quanto os LEDs (do inglês light emitting diodes) constituem fontes de luz adequadas para que os efeitos citotóxicos da terapia fotodinâmica resultem na destruição do tumor ou seus efeitos imunomodulatórios atuem melhorando as condições inflamatórias cutâneas. Palavras-chave: Carcinoma basocelular; Carcinoma in situ; Fotoquimioterapia Abstract: Photodynamic therapy involves the administration of a photosensitizing drug and its subsequent activation by light at wavelengths matching the absorption spectrum of the photosensitizer. Currently, topical photodynamic therapy has received approval for the treatment of cutaneous oncologic conditions such as actinic keratoses, Bowen's disease and superficial basal cell carcinoma in many countries in the world. Multicenter randomized controlled studies have demonstrated high efficacy and superior cosmetic outcome over standard therapies. For many non-oncologic dermatological diseases such as acne vulgaris, viral warts and localized scleroderma, case reports and small series have confirmed the potential of photodynamic therapy. After the development of topical photosensitizers 5-aminolevulinic acid (ALA) or its methyl ester (MAL), photodynamic therapy has gained worldwide popularity in dermatology, as these drugs do not induce prolonged phototoxicity as the systemic photosensitizing hematoporphyrin derivatives do. The production of reactive oxygen intermediates such as singlet oxygen depends on the concentration and localization of the photosensitizer in the diseased tissue as well as the applied light dose. Either incoherent lamps or LED arrays are suitable for the cytotoxic effects resulting in tumor destruction or immunomodulator...

show abstract

“…For example, in a multicenter, prospectively not controlled study which included patients with recurrent superficial and nodular basal cell lesions, with a risk of complications, with previously poor cosmetic results, it was found that after two PDT sessions carried out in a one week interval the clinical remission at 3 months was 92% for the superficial forms and 87% for the nodular ones. Histological negative margins was obtained in 85% of the superficial basal cell carcinomas and in 75% of the nodular ones (Horn et al, 2003). ALA-PDT can be used as adjuvant therapy in Mohs microsurgery for the BCC after the excision of the tumor.…”

Section: Basal Cell Carcinomamentioning

confidence: 99%