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Daylight PDT

Piergiacomo Calzavara-Pinton, Merete Hædersdal, Kirk Barber, Nicole Basset-Seguin, María Emilia Del Pino Flores, Peter Foley, Gaston Galimberti, Rianne Gerritsen, Yolanda Gilarbete, Sally Ibbotson, Ketty Peris, Sheetal Sapra, Eleni Sotiriou, Luis Torezan, Claas Ulrich, Jonathan Guillemot, Janek Hendrich, Rolf-Markus Szeimies
BACKGROUND: A practical and up-to-date consensus among experts is paramount to further improve patient care in actinic keratosis (AK). OBJECTIVES: To develop a structured consensus statement on the diagnosis, classification, and practical management of AK based on up-to-date information. METHODS: A systematic review of AK clinical guidelines was conducted. This informed the preparation of a 3-round Delphi procedure followed by a consensus meeting, which combined the opinions of 16 clinical experts from 13 countries, to construct a structured consensus statement and a treatment algorithm positioning daylight photodynamic therapy (dl-PDT) among other AK treatment options...
April 1, 2017: Journal of Cutaneous Medicine and Surgery
G Fathy, M K Asaad, H M Rashid
Photodynamic therapy (PDT) is a technique that utilizes reactive oxygen species produced by a non-toxic dye or photosensitizer molecule in the presence of low intensity visible light to kill mammalian or microbial cells ((1)) . The advantages of PDT are numerous, it is a safe, non-invasive technique which yields effective therapeutic results ((2)) . Photodynamic therapy is not free of adverse effects. The most common one is pain during illumination. With the use of portable light sources to optimize the procedure and facilitate outpatient treatment, the concept of ambulatory PDT has emerged...
February 15, 2017: Photodermatology, Photoimmunology & Photomedicine
Connor Thunshelle, Rui Yin, Qiquan Chen, Michael R Hamblin
Kennedy and Pottier discovered that photodynamic therapy (PDT) could be carried out using a procedure consisting of topical application of the porphyrin-precursor, 5-aminolevulinic acid (ALA) to the skin, followed after some time by illumination with various light parameters in the 1980s. Since then, ALA-PDT has expanded enormously and now covers most aspects of dermatological disease. The purpose of this review is to discuss a range of ingenious strategies that investigators have devised for improving the overall outcome (higher efficiency and lower side effects) of ALA-PDT...
September 2016: Current Dermatology Reports
Christoffer V Nissen, Ida Marie Heerfordt, Stine R Wiegell, Carsten S Mikkelsen, Hans C Wulf
The efficacy of photodynamic therapy (PDT) with methyl aminolevulinate is reduced when treating actinic keratosis (AK) on the extremities in comparison with the face and scalp. Studies indicate that PDT efficacy can be improved by combining PDT with other treatment modalities. This randomized intra-individual study investigated whether pretreatment with topical 5% 5-fluorouracil (5-FU) enhanced the treatment efficacy of daylight-mediated PDT in 24 patients with AKs on the hands. One hand of each patient was given 7 days of pretreatment with 5-FU twice daily before daylight-PDT, whereas the other hand was treated with daylight-PDT alone...
January 17, 2017: Acta Dermato-venereologica
A Tomás-Velázquez, P Redondo
Actinic keratosis is a precursor lesion to the most common nonmelanoma skin cancer. Conventional photodynamic therapy (PDT) has been shown to be effective, but the procedure is time-consuming, can be very painful, and requires infrastructure. These shortcomings led to the emergence of daylight PDT. To obtain a global estimate of efficacy, we undertook a systematic literature review and performed a meta-analysis of the available evidence on the efficacy and safety of daylight PDT as compared to conventional PDT in the treatment of actinic keratosis and/or field cancerization...
January 4, 2017: Actas Dermo-sifiliográficas
Hanan Osman-Ponchet, Karine Sevin, Alexandre Gaborit, Magali Kouidhi, Johanna Hanaizi, Pierre Comby, Bernard Ruty, Guy Bouvier
BACKGROUND: Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers. Methyl-aminolevulinate (MAL) is metabolized to protoporphyrin IX (PpIX) which accumulates in the skin lesion and which generates a painful photochemical toxic reaction upon red light exposure. PDT using daylight (DL) exposure is now used to reduce pain and subjects are advised to protect the areas with sunscreen. This work investigated the effect of sunscreen on MAL penetration and PpIX photoactivation in ex vivo human skin...
November 26, 2016: Photodiagnosis and Photodynamic Therapy
Sally Ibbotson, Robin Stones, Jonathan Bowling, Sandra Campbell, Stephen Kownacki, Muthu Sivaramakrishnan, Ronan Valentine, Colin A Morton
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...
October 27, 2016: Journal of Dermatological Treatment
Liezel L Griffin, John T Lear
Non-melanoma skin cancer (NMSC) is the most common malignancy among the Caucasian population. Photodynamic therapy (PDT) is gaining popularity for the treatment of basal cell carcinoma (BCC), Bowen's disease (BD) and actinic keratosis (AK). A topical or systemic exogenous photosensitiser, results in selective uptake by malignant cells. Protoporphyrin IX (PpIX) is produced then activated by the introduction of a light source. Daylight-mediated MAL (methyl aminolaevulinate) PDT for AKs has the advantage of decreased pain and better patient tolerance...
October 22, 2016: Cancers
P O'Mahoney, M Khazova, M Higlett, T Lister, S Ibbotson, E Eadie
BACKGROUND: Daylight PDT (dPDT) is an effective and nearly painless treatment for field-change actinic keratosis. Measuring the protoprophyrin-IX (PpIX)-weighted exposure dose can give an indication of when conditions are most viable for effective dPDT. It would be advantageous for practitioners if more detailed information of exposure dose and appropriate treatment conditions were available. Where sophisticated measurement equipment is unavailable, simpler and more cost-effective methods of dose measurement are desirable...
October 24, 2016: British Journal of Dermatology
C L Campbell, C T A Brown, K Wood, H Moseley
Most existing theoretical models of photodynamic therapy (PDT) assume a uniform initial distribution of the photosensitive molecule, Protoporphyrin IX (PpIX). This is an adequate assumption when the prodrug is systematically administered; however for topical PDT this is no longer a valid assumption. Topical application and subsequent diffusion of the prodrug results in an inhomogeneous distribution of PpIX, especially after short incubation times, prior to light illumination. In this work a theoretical simulation of PDT where the PpIX distribution depends on the incubation time and the treatment modality is described...
October 7, 2016: Physics in Medicine and Biology
Erica Moggio, Mariachiara Arisi, Cristina Zane, Irene Calzavara-Pinton, PierGiacomo Calzavara-Pinton
INTRODUCTION: Daylight photodynamic therapy with methyl aminolaevulinate (dlPDT) and ingenol mebutate gel (IMB) are approved therapeutic options for multiple actinic keratoses (AKs). The aim of this comparative, intra-patient, split-face, randomized clinical trial was to compare treatment outcomes of dlPDT and IMB. METHODS: Two symmetrical contralateral areas of 25cm(2), harboring a similar (5-10) number of AKs, were selected and randomly assigned either to a 3days' IMB treatment cycle or to a single session of dlPDT...
December 2016: Photodiagnosis and Photodynamic Therapy
Michael Mühlstädt
We present the case of a 73-year-old male patient who had received a first renal transplant at 36 years and a second one at the age of 55 years. He is currently under immunosuppression with everolimus 2.5 mg/day and prednisone 5 mg/day. The patient presented with multiple actinic keratoses on both cheeks and the forehead and received treatment by ingenol mebutate 150 µg/g gel daily on 3 consecutive days on his right cheek and methyl aminolevulinate (MAL) photodynamic therapy activated by daylight (MAL-dPDT) on the forehead and the left cheek...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Carmen Cantisani, Giovanni Paolino, Giovanni Pellacani, Dario Didona, Marco Scarno, Valentina Faina, Tommaso Gobello, Stefano Calvieri
Non-melanoma skin cancer is the most common skin cancer with an incidence that varies widely worldwide. Among them, actinic keratosis (AK), considered by some authors as in situ squamous cell carcinoma (SCC), are the most common and reflect an abnormal multistep skin cell development due to the chronic ultraviolet (UV) light exposure. No ideal treatment exists, but the potential risk of their development in a more invasive form requires prompt treatment. As patients usually present with multiple AK on fields of actinic damage, there is a need for effective, safe, simple and short treatments which allow the treatment of large areas...
July 11, 2016: International Journal of Molecular Sciences
Piergiacomo Calzavara-Pinton, Cristina Zane, Maud Pacou, Rolf-Markus Szeimies
Actinic keratosis (AK) is a pre-cancerous condition characterised by patches of thick, scaly skin developing on sun-exposed areas of the body. When multiple AKs develop on severely photodamaged skin, commonly used treatments include photodynamic therapy and diclofenac plus hyaluronic acid gel (DHA). Methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) is an alternative to conventional photodynamic therapy (MAL c-PDT). Trials have indicated that MAL DL-PDT is as effective as MAL c-PDT but reduces treatment-related pain and dermatological side effects...
June 28, 2016: European Journal of Dermatology: EJD
A Rossi, V Garelli, G Pranteda, M Cardone, A Anzalone, M C Fortuna, D Di Nunno, E Mari, G De Vita, M Carlesimo
Actinic keratosis (AK) is a keratinocyte intraepidermal neoplasia UV light-induced that frequently appears in sun-exposed areas of the skin. Although historically AK was defined as "precancerous", actually it is considered as the earliest stage of squamous cell carcinoma (SCC) in situ. Since AKs can progress into invasive SCC, their treatment is recommended. AKs rarely develop as a single lesion; usually multiple lesions commonly affect an entire area of chronically actinic damaged skin. This has led to the concept of "field cancerization", an area chronically sun-exposed that surrounds peripherally visible lesions, in which are individualized subclinical alterations...
September 2016: Journal of Photochemistry and Photobiology. B, Biology
Lasse R Braathen, Colin A Morton, Rolf-Markus Szeimies
UNLABELLED: We provide a summary of the presentations made at the recent Euro-PDT annual Congress. Presentations covered developments in topical photodynamic therapy (PDT) pertaining to dermatological applications. Recognizing the high prevalence and chronicity of actinic keratosis, one of the approved indications for PDT, there were recommendations to pursue field therapy to treat clinical and preclinical lesions. A separate section was reserved to review the strong evidence for the use of daylight PDT for actinic keratosis and experience of use of this well tolerated form of PDT was reported from several countries...
September 2016: Dermatology and Therapy
Beni Grinblat, Gaston Galimberti, Gonzalo Pantoja, Gloria Sanclemente, Miguel Lopez, Daniel Alcala, Luís Torezan, Delphine Kerob, Thierry Pascual, Edgardo Chouela
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/m(2) (range: 40-585 W/m(2) ). 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...
September 2016: International Journal of Dermatology
C Girard, H Adamski, N Basset-Séguin, P Beaulieu, B Dreno, J-L Riboulet, J-P Lacour
Actinic keratosis (AK), also known as solar keratosis or pre-cancerous keratosis, is frequently observed in areas of skin exposed to sunlight, particularly in light-skinned patients. In France, photodynamic therapy using red light (conventional PDT) and methylamino 5-levulinate (MAL) is indicated in the treatment of thin or non-hyperkeratotic and non-pigmented multiple AK lesions or large zones covered with AK lesions. It is well-known for its efficacy but also for its side effects, especially pain during illumination, which can limit its use...
April 2016: Annales de Dermatologie et de Vénéréologie
S M Seyed Jafari, T Timchik, R E Hunger
BACKGROUND: Reflectance confocal microscopy (RCM) is a noninvasive diagnostic technique with an acceptable sensitivity and specificity for actinic keratosis (AK). OBJECTIVES: We evaluated efficacy of daylight photodynamic therapy (DL-PDT) in patients with AK using a new RCM atypia scoring system. MATERIALS AND METHODS: All patients with AK lesions (Grade I-II) were included in our study (2012-15). Baseline clinical, dermoscopy and RCM evaluations were followed by DL-PDT...
August 2016: British Journal of Dermatology
Catharina M Lerche, Ida M Heerfordt, Jakob Heydenreich, Hans Christian Wulf
Daylight-mediated photodynamic therapy (daylight PDT) is a simple and pain free treatment of actinic keratoses. Weather conditions may not always allow daylight PDT outdoors. We compared the spectrum of five different lamp candidates for indoor "daylight PDT" and investigated their ability to photobleach protoporphyrin IX (PpIX). Furthermore, we measured the amount of PpIX activating daylight available in a glass greenhouse, which can be an alternative when it is uncomfortable for patients to be outdoors. The lamps investigated were: halogen lamps (overhead and slide projector), white light-emitting diode (LED) lamp, red LED panel and lamps used for conventional PDT...
February 29, 2016: International Journal of Molecular Sciences
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