Weather conditions and daylight-mediated photodynamic therapy: protoporphyrin IX-weighted daylight doses measured in six geographical locations

Wiegell, Stine Regin; Fabricius, Susanne; Heydenreich, Jakob; Enk, Claes D.; Rosso, Sebastián Del; Bäumler, Wolfgang; Baldursson, B.T.; Wulf, Hans Christian

doi:10.1111/j.1365-2133.2012.11200.x

Cited by 101 publications

(99 citation statements)

References 16 publications

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“…One way to deliver very low irradiance PDT is by the use of daylight to activate PpIX. It has been demonstrated that for patients with AKs and in particular field AKs, PDT using daylight can have a similar efficacy to c-PDT, is almost pain free and produces excellent cosmetic results (22)(23)(24)(25)(26)(27)(28)(29)(30). However, it is important to note that in these studies, the efficacy of d-PDT was only followed up over 3-6 months, although with high efficacy rates still apparent at six months (31,32) and this is also typical of the follow-up interval used in most studies of most treatments for AK.…”

Section: Conventional Pdt (C-pdt)mentioning

confidence: 99%

“…Initial efficacy and safety studies of d-PDT with MAL were conducted in Copenhagen (22)(23)(24)(25)(26). Subsequently, studies were conducted in central and southern Europe, Brazil and Australia (27,(29)(30)(31).…”

Section: Clinical Experience With D-pdtmentioning

confidence: 99%

“…In Europe, the mean rate of clearance of AKs was 75-83% after one treatment for patients with Grade I/II AKs (22)(23)(24)(25)(26)(27)29). In Australia and Brazil, the response was greater, at 89% and 88%, respectively, for patients with mild AKs (30,31).…”

Section: Clinical Experience With D-pdtmentioning

confidence: 99%

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A consensus on the use of daylight photodynamic therapy in the UK

Ibbotson

Stones

Bowling³

et al. 2016

Journal of Dermatological Treatment

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Background: Actinic keratoses (AKs) are a consequence of chronic exposure to ultraviolet radiation. Treatment of chronically photo-damaged skin and AKs is driven by risk of progression to squamous cell carcinoma, as well as for symptomatic relief. Conventional photodynamic therapy (c-PDT) is indicated when AKs are multiple or confluent and if patients respond poorly or are unable to tolerate other therapies. c-PDT is limited by the field size that can be treated in single sessions and can cause significant discomfort. Objective: Recent studies investigated daylight illumination to activate protoporphyrin IX and daylight-PDT (d-PDT) is now licensed in the UK for face and scalp AKs. A group of experts met to discuss application of d-PDT with methyl aminolevulinate (MAL) and develop a UK consensus statement, specific to UK weather conditions. Methods: The UK consensus recommendations were reached among eight experts, who reviewed recent studies on d-PDT, assessed UK meteorological data and discussed personal experiences of d-PDT for AKs. Results: Recommendations from these discussions provide guidance on d-PDT use, specifically regarding patient selection, therapeutic indications, when to treat, skin preparation, MAL application and daylight exposure for patients with AKs. Conclusions: This UK expert consensus provides practical guidance for UK application of d-PDT.

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Section: Conventional Pdt (C-pdt)mentioning

confidence: 99%

Section: Clinical Experience With D-pdtmentioning

confidence: 99%

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A consensus on the use of daylight photodynamic therapy in the UK

Ibbotson

Stones

Bowling³

et al. 2016

Journal of Dermatological Treatment

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“…Since assuring constant conditions for daylight-PDT is difficult [100], simulated daylight-PDT (SDL-PDT) has been developed. It can be performed in the doctor's office under standardized, constant conditions with the possibility to monitor the patient at all times.…”

Section: Pdt With Natural and Simulated Daylightmentioning

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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“…Wiegell et al recently demonstrated that the light dose required to activate protoporphyrin IX (PpIX) is influenced by latitude, weather conditions, and time of year. 16 To address these important concerns, Spelman et al conducted a meteorological study assessing the suitability of daylight to perform DL-PDT throughout an entire year in eight locations in Australia. 17 This study concluded that DL-PDT can be performed effectively throughout the year as long as weather conditions permit exposure to daylight for 2 hours.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of daylight‐mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study

Grinblat

Galimberti

Pantoja³

et al. 2016

Int J Dermatology

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Summary Background Daylight‐mediated photodynamic therapy (DL‐PDT) is an efficacious treatment option for thin actinic keratosis (AK) that offers advantages over conventional PDT in terms of tolerability, treatment duration, and cost. A clinical study conducted in Australia determined the mean irradiance during a 2‐hour exposure to be 305.8 W/m2 (range: 40–585 W/m2). The protoporphyrin IX light dose is influenced by latitude, weather conditions, and time of year. A recent study of meteorological data concluded that DL‐PDT can be performed effectively throughout the year in Australia. Objectives Based on the same hypothesis and applying the same methodology, the present study investigated the suitability of daylight to perform DL‐PDT in Central and South America. Methods Solar radiation and weather data were gathered and analyzed to assess daylight irradiance (light intensity) throughout a full year across 32 geographical locations in Central and South America. Results The minimum average daily solar irradiance reported was above 305.8 W/m2 in all locations investigated throughout the year. Annual averages of daily irradiance ranged from 578 W/m2 in Chihuahua, Mexico, to 321 W/m2 in Puerto Montt, Chile. Conclusions Daylight‐mediated PDT for AK can be performed effectively throughout the year in Central and South America given that weather conditions permit a comfortable 2‐hour direct exposure to daylight.

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Weather conditions and daylight-mediated photodynamic therapy: protoporphyrin IX-weighted daylight doses measured in six geographical locations

Cited by 101 publications

References 16 publications

A consensus on the use of daylight photodynamic therapy in the UK

A consensus on the use of daylight photodynamic therapy in the UK

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

Feasibility of daylight‐mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study

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