Skip to main content

Advertisement

Log in

Combination of photodynamic therapy and immunomodulation for skin diseases—update of clinical aspects

  • Perspective
  • Published:
Photochemical & Photobiological Sciences Aims and scope Submit manuscript

Abstract

In dermatology, photodynamic therapy (PDT) has become a well established treatment modality which has been shown to be effective and safe for many skin and mucosal disorders. Pre-clinical and clinical studies demonstrate that, in addition to the direct local cytotoxicity and vascular effects, PDT can induce various host immune responses. Recent clinical data also show that improved clinical outcomes can be obtained through the sequential use of PDT and immunomodulation. This article will provide an update on the current status of such a combination in dermatological applications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. I. J. MacDonald and T. J. Dougherty, Basic principle of photodynamic therapy, J. Porphyrins Phthalocyanines, 2001, 5, 105–129.

    Article  CAS  Google Scholar 

  2. A. P. Castano, T. N. Demidova and M. R. Hamblin, Mechanisms in photodynamic therapy: Part three–Photosensitizer pharmacokinetics, biodistribution, tumor localization and modes of tumor destruction, Photodiagn. Photodyn. Ther., 2005, 2, 91–106.

    Article  CAS  Google Scholar 

  3. Z. Huang, H. Xu, A. D. Meyers, A. I. Musani, L. Wang, R. Tagg, A. B. Barqawi and Y. K. Chen, Photodynamic therapy for treatment of solid tumors–potential and technical challenges, Technol. Cancer Res. Treat., 2008, 7, 309–320.

    Article  CAS  PubMed  Google Scholar 

  4. Z. Huang, A review of progress in clinical photodynamic therapy, Technol. Cancer Res. Treat., 2005, 4, 283–294.

    Article  CAS  PubMed  Google Scholar 

  5. Z. Huang, L. Li, H. Wang, X. Wang, K. Yuan, A. D. Meyers, L. Yang and F. W. Hetzel, Photodynamic therapy–an update on clinical applications, J. Innovative Opt. Health Sci., 2009, 2, 73–92.

    Article  Google Scholar 

  6. B. Chen, B. W. Pogue, P. J. Hoopes and T. Hasan, Vascular and cellular targeting for photodynamic therapy, Crit. Rev. Eukaryot. Gene Expr., 2006, 16, 279–305.

    Article  PubMed  Google Scholar 

  7. U. Schmidt-Erfurth and T. Hasan, Mechanisms of action of photodynamic therapywith verteporfin for the treatment of age-related macular degeneration, Surv. Ophthalmol., 2000, 45, 195–214.

    Article  CAS  PubMed  Google Scholar 

  8. N. M. Bressler, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group, Photodynamic therapy of subfoveal choroidal neovascularisation in age-related macular degenerationwith verteporfin: two-year results of 2 randomized clinical trials–TAP report 2, Arch. Ophthalmol., 2001, 119, 198–207.

    CAS  PubMed  Google Scholar 

  9. K. H. Yuan, Q. Li, W. L. Yu and Z. Huang, Photodynamic therapy in treatment of port wine stain birthmarks–recent progress, Photodiagn. Photodyn. Ther., 2009, 6, 189–194.

    Article  CAS  Google Scholar 

  10. Z. Huang, Q. Chen, K. C. Dole, A. B. Barqawi, Y. K. Chen, D. Blanc, B. C. Wilson and F. W. Hetzel, The effect of Tookad-mediated photodynamic ablation of the prostate gland on adjacent tissues–in vivo study in a canine model, Photochem. Photobiol. Sci., 2007, 6, 1318–1324.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. P. Babilas and R. M. Szeimies, The use of photodynamic therapy in dermatology, G. Ital. Dermatol. Venereol., 2010, 145, 613–630.

    CAS  PubMed  Google Scholar 

  12. J. C. Kennedy, R. H. Pottier and D. C. Pross, Photodynamic therapy with endogenous protoporphyrin IX: basic principles and present clinical experience, J. Photochem. Photobiol., B, 1990, 6, 143–148.

    Article  CAS  Google Scholar 

  13. E. H. Tschen, D. S. Wong, D. M. Pariser, F. E. Dunlap, A. Houlihan and M. B. Ferdon, Phase IV ALA-PDT Actinic Keratosis Study Group. Photodynamic therapy using aminolaevulinic acid for patients with nonhyperkeratotic actinic keratoses of the face and scalp: phase IV multicentre clinical trial with 12-month follow up, Br. J. Dermatol., 2006, 155, 1262–1269.

    Article  CAS  PubMed  Google Scholar 

  14. G. I. Stables, M. R. Stringer, D. J. Robinson and D. V. Ash, Large patches of Bowen’s disease treated by topical aminolaevulinic acid photodynamic therapy, Br. J. Dermatol., 1997, 136, 957–960.

    Article  CAS  PubMed  Google Scholar 

  15. X. L. Wang, H. W. Wang, M. X. Guo and S. Z. Xu, Treatment of skin cancer and pre-cancer using topical ALA-PDT–A single hospital experience, Photodiagn. Photodyn. Ther., 2008, 5, 127–133.

    Article  Google Scholar 

  16. L. R. Braathen, R. M. Szeimies, N. Basset-Seguin, R. Bissonnette, P. Foley, D. Pariser, R. Roelandts, A. M. Wennberg and C. A. Morton, International Society for Photodynamic Therapy in Dermatology, Guidelines on the use of photodynamic therapy for nonmelanoma skin cancer: an international consensus. International Society for Photodynamic Therapy in Dermatology 2005, J. Am. Acad. Dermatol., 2007, 56, 125–143.

    Article  PubMed  Google Scholar 

  17. E. Sotiriou, Z. Apalla, T. Koussidou-Erremonti and D. Ioannides, Actinic cheilitis treated with one cycle of 5-aminolaevulinic acid-based photodynamic therapy: report of 10 cases, Br. J. Dermatol., 2008, 159, 261–262.

    Article  CAS  PubMed  Google Scholar 

  18. C. S. Souza, A. B. Neves, L. A. Felício, J. Ferreira, C. Kurachi and V. S. Bagnato, Optimized photodynamic therapy with systemic photosensitizer following debulking technique for nonmelanoma skin cancers, Dermatol. Surg., 2007, 33, 194–198.

    CAS  PubMed  Google Scholar 

  19. J. A. Leman, D. C. Dick and C. A. Morton, Topical 5-ALA photodynamic therapy for the treatment of cutaneous T-cell lymphoma, Clin. Exp. Dermatol., 2002, 27, 516–518.

    Article  CAS  PubMed  Google Scholar 

  20. A. F. Nikkels, L. Thirion, P. Quatresooz and G. E. Piérard, Photodynamic therapy for cutaneous verrucous carcinoma, J. Am. Acad. Dermatol., 2007, 57, 516–519.

    Article  PubMed  Google Scholar 

  21. F. Raspagliesi, R. Fontanelli, G. Rossi, A. Ditto, E. Solima, F. Hanozet and S. Kusamura, Photodynamic therapy using a methyl ester of 5-aminolevulinic acid in recurrent Paget’s disease of the vulva: a pilot study, Gynecol. Oncol., 2006, 103, 581–586.

    Article  CAS  PubMed  Google Scholar 

  22. L. Li, Y. Deng, L. Zhang, W. Liao, R. Luo and Z. Huang, Treatment of perianal Paget’s disease using photodynamic therapy with assistance of fluorescence examination: case report, Lasers Med. Sci., 2009, 24, 981–984.

    Article  PubMed  Google Scholar 

  23. S. Piaserico, A. Belloni Fortina, P. Rigotti, B. Rossi, N. Baldan, M. Alaibac and F. Marchini, Topical photodynamic therapy of actinic keratosis in renal transplant recipients, Transplant Proc., 2007, 39, 1847–1850.

    Article  CAS  PubMed  Google Scholar 

  24. C. M. Perrett, J. M. McGregor, J. Warwick, P. Karran, I. M. Leigh, C. M. Proby and C. A. Harwood, Treatment of post-transplant premalignant skin disease: a randomized intrapatient comparative study of 5-fluorouracil cream and topical photodynamic therapy, Br. J. Dermatol., 2007, 156, 320–328.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. X. L. Wang, H. W. Wang, L. L Zhang, M. X. Guo and Z. Huang, Topical ALA PDT for the treatment of severe acne vulgaris, Photodiagn. Photodyn. Ther., 2010, 7, 33–38.

    Article  CAS  Google Scholar 

  26. M. Horn and P. Wolf, Topical methyl aminolevulinate photodynamic therapy for the treatment of folliculitis, Photodermatol., Photoimmunol. Photomed., 2007, 23, 145–147.

    Article  Google Scholar 

  27. T. Smits, M. M. Kleinpenning, P. E. van Erp, P. C. van de Kerkhof and M. J. Gerritsen, A placebo-controlled randomized study on the clinical effectiveness, immunohistochemical changes and protoporphyrin IX accumulation in fractionated 5-aminolaevulinic acid-photodynamic therapy in patients with psoriasis, Br. J. Dermatol., 2006, 155, 429–436.

    Article  CAS  PubMed  Google Scholar 

  28. V. Schleyer, S. Radakovic-Fijan, S. Karrer, T. Zwingers, A. Tanew, M. Landthaler and R. M. Szeimies, Disappointing results and low tolerability of photodynamic therapy with topical 5-aminolaevulinic acid in psoriasis. A randomized, double-blind phase I/II study, J. Eur. Acad. Dermatol. Venereol., 2006, 20, 823–828.

    CAS  PubMed  Google Scholar 

  29. D. Wilsmann-Theis, T. Bieber and N. Novak, Photodynamic therapy as an alternative treatment for cutaneous sarcoidosis, Dermatology, 2008, 217, 343–346.

    Article  PubMed  Google Scholar 

  30. P. Weisenseel, A. V. Kuznetsov, S. Molin, T. Ruzicka, C. Berking and J. C. Prinz, Photodynamic therapy for granuloma annulare:More than a shot in the dark, Dermatology, 2008, 217, 329–332.

    Article  PubMed  Google Scholar 

  31. R. Batchelor, S. Lamb, V. Goulden, G. Stables, M. Goodfield and W. Merchant, Photodynamic therapy for the treatment of morphoea, Clin. Exp. Dermatol., 2008, 33, 661–663.

    Article  CAS  PubMed  Google Scholar 

  32. X. L. Wang, H. W. Wang, H. S. Wang, S. Z. Xu, K. H. Liao and P. Hillemanns, Topical 5-aminolaevulinic acid-photodynamic therapy for the treatment of urethral condylomata acuminate, Br. J. Dermatol., 2004, 151, 880–885.

    Article  CAS  PubMed  Google Scholar 

  33. K. Chen, B. Z. Chang, M. Ju, X. H. Zhang and H. Gu, Comparative study of photodynamic therapy vs. CO2 laser vaporization in treatment of condylomata acuminata: a randomized clinical trial, Br. J.Dermatol., 2007, 156, 516–520.

    Article  CAS  PubMed  Google Scholar 

  34. X. L. Wang, H. W. Wang, Z. Huang, H. Stepp, R. Baumgartner, C. Dannecker and P. Hillemanns, Study of protoporphyrin IX (PpIX) pharmacokinetics after topical application of 5-aminolevulinic acid in urethral condylomata acuminate, Photochem. Photobiol., 2007, 83, 1069–1073.

    Article  CAS  PubMed  Google Scholar 

  35. M. Wainwright, Photodynamic antimicrobial chemotherapy (PACT), J. Antimicrob. Chemother., 1998, 42, 13–28.

    Article  CAS  PubMed  Google Scholar 

  36. G. Jori and S. B. Brown, Photosensitized inactivation of microorganisms, Photochem. Photobiol. Sci., 2004, 3, 403–405.

    Article  CAS  PubMed  Google Scholar 

  37. T. Dai, Y. Huang and M. R. Hamblin, Photodynamic therapy for localized infections–State of the art, Photodiagn. Photodyn. Ther., 2009, 6, 170–188.

    Article  CAS  Google Scholar 

  38. R. F. Donnelly, P. A. McCarron and M. M. Tunney, Antifungal photodynamic therapy, Microbiol. Res., 2008, 163, 1–12.

    Article  CAS  PubMed  Google Scholar 

  39. M. Grinholc, B. Szramka, K. Olender and A. Graczyk, Bactericidal effect of photodynamic therapy against methicillin-resistant Staphylococcus aureus strain with the use of various porphyrin photosensitizers, Acta Biochim. Pol., 2007, 54, 665–670.

    Article  CAS  PubMed  Google Scholar 

  40. L. E. Bryld and G. B. Jemec, The bacterial flora of the skin surface following routine MAL-PDT, J. Dermatol. Treat., 2006, 17, 222–223.

    Article  Google Scholar 

  41. T. H. Clayton and P. V. Harrison, Photodynamic therapy for infected leg ulcers, Br. J. Dermatol., 2007, 156, 384–385.

    Article  CAS  PubMed  Google Scholar 

  42. S. Motta and M. Monti, Photodynamic therapy–a promising treatment option for autoimmune skin ulcers: a case report, Photochem. Photobiol. Sci., 2007, 6, 1150–1151.

    Article  CAS  PubMed  Google Scholar 

  43. L. Bakos, G. Zoratto, L. Brunetto, N. Mazzotti and A. Cartell, Photodynamic therapy: a useful adjunct therapy for recalcitrant ulceration in pemphigus vulgaris, J. Eur. Acad. Dermatol. Venereol., 2009, 23, 599–600.

    Article  CAS  PubMed  Google Scholar 

  44. C. D. Enk, C. Fritsch, F. Jonas, A. Nasereddin, A. Ingber, C. L. Jaffe and T. Ruzicka, Treatment of cutaneous leishmaniasis with photodynamic therapy, Arch. Dermatol., 2003, 139, 432–434.

    Article  PubMed  Google Scholar 

  45. O. E. Akilov, S. Kosaka, K. O’Riordan and T. Hasan, Parasiticidal effect of delta-aminolevulinic acid-based photodynamic therapy for cutaneous leishmaniasis is indirect and mediated through the killing of the host cells, Exp. Dermatol., 2007, 16, 651–660.

    Article  CAS  PubMed  Google Scholar 

  46. A. Orenstein, J. S. Nelson, L. H. Liaw, R. Kaplan, S. Kimel and M. W. Berns, Photochemotherapy of hypervascular dermal lesions: a possible alternative to photothermal therapy?, Lasers Surg.Med., 1990, 10, 334–343.

    Article  CAS  PubMed  Google Scholar 

  47. S. Kimel, L. O. Svaasand, K. M. Kelly and J. S. Nelson, Synergistic photodynamic and photothermal treatment of port-wine stain?, Lasers Surg. Med., 2004, 34, 80–82.

    Article  PubMed  Google Scholar 

  48. Z. P. Qin, K. L. Li, L. Ren and X. J. Liu, Photodynamic therapy of port wine stains - a report of 238 cases, Photodiagn. Photodyn. Ther., 2007, 4, 53–59.

    Article  Google Scholar 

  49. K. H. Yuan, Q. Li, W. L. Yu, D. Zeng, C. Zhang and Z. Huang, Comparison of photodynamic therapy and pulsed dye laser in patients with port wine stain birthmarks: A retrospective analysis, Photodiagn. Photodyn. Ther., 2008, 5, 50–57.

    Article  Google Scholar 

  50. K. H. Yuan, Q. B. Huang and Z. Huang, Combination of PDT and topical angiogenic inhibitor for treatment of port wine stain (PWS) birthmarks–A novel approach, Proc. SPIE, 2009, 7380, 73802V1–73802V9.

    Google Scholar 

  51. M. Korbelik, Induction of tumor immunity by photodynamic therapy, J. Clin. Laser Med. Surg., 1996, 14, 329–334.

    Article  CAS  PubMed  Google Scholar 

  52. S. O. Gollnick, B. Owczarczak and P. Maier, Photodynamic therapy and anti-tumor immunity, Lasers Surg. Med., 2006, 38, 509–515.

    Article  PubMed  Google Scholar 

  53. A. P. Castano, P. Mroz and M. R. Hamblin, Photodynamic therapy and anti-tumour immunity, Nat. Rev. Cancer, 2006, 6, 535–545.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. D. Nowis, T. Stokłosa, M. Legat, T. Issat, M. Jakóbisiak and J. Gołąb, The influence of photodynamic therapy on the immune response, Photodiagn. Photodyn. Ther., 2005, 2, 283–298.

    Article  CAS  Google Scholar 

  55. Y. G. Qiang, C. M. Yow and Z. Huang, Combination of photodynamic therapy andimmunomodulation: current status and future trends, Med. Res. Rev., 2008, 28, 632–644.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. U. R. Hengge and T. Ruzicka, Topical immunomodulation in dermatology: potential of toll-like receptor agonists, Dermatol. Surg., 2004, 30, 1101–1112.

    PubMed  Google Scholar 

  57. E. Sotiriou, Z. Apalla, F. Maliamani, N. Zaparas, D. Panagiotidou and D. Ioannides, Intraindividual, right-left comparison of topical 5-aminolevulinic acid photodynamic therapy vs. 5% imiquimod cream for actinic keratoses on the upper extremities, J. Eur. Acad. Dermatol. Venereol., 2009, 23, 1061–1065.

    Article  CAS  PubMed  Google Scholar 

  58. A. F. Nikkels, C. Pierard-Franchimont, N. Nikkels-Tassoudji, R. Bourguignon and G. E. Pierard, Photodynamic therapy and imiquimod immunotherapy for basal cell carcinomas, Acta. Clin. Belg., 2005, 60, 227–234.

    Article  CAS  PubMed  Google Scholar 

  59. V. Devirgiliis, V. Panasiti, M. Curzio, S. Gobbi, M. Rossi, V. Roberti and S. Calvieri, Complete remission of nodular basal cell carcinoma after combined treatment with photodynamic therapy and imiquimod 5% cream, Dermatol. Online J., 2008, 14, 25.

    PubMed  Google Scholar 

  60. V. Madan, C. A. West, J.V. Murphy and J. T. Lear, Sequential treatment of giant basal cell carcinomas, J. Plast., Reconstr. Aesthetic Surg., 2009, 62, e368–372.

    Article  CAS  Google Scholar 

  61. M. Shaffelburg, Treatment of actinic keratoses with sequential use of photodynamic therapy; and imiquimod 5% cream, J. Drugs Dermatol., 2009, 8, 35–39.

    PubMed  Google Scholar 

  62. J. M. Ricart, J. Cordoba, M. Hernandez and I. Esplugues, Extensive genital bowenoid papulosis responding to imiquimod, J. Eur. Acad. Dermatol. Venereol., 2007, 21, 113–115.

    Article  CAS  PubMed  Google Scholar 

  63. W. Petrow, R. Gerdsen, M. Uerlich, O. Richter and T. Bieber, Successful topical immunotherapy of bowenoid papulosis with imiquimod, Br. J. Dermatol., 2001, 145, 1022–1023.

    Article  CAS  PubMed  Google Scholar 

  64. O. N. Richter, W. Petrow, E. Wardelmann, C. Dorn, M. Kupka and U. Ulrich, Bowenoid papulosis of the vulva-immunotherapeutical approach with topical imiquimod, Arch. Gynecol. Obstet., 2003, 268, 333–336.

    Article  CAS  PubMed  Google Scholar 

  65. X. L. Wang, H. W. Wang, M. X. Guo and Z. Huang, Combination of immunotherapy and photodynamic therapy in the treatment of Bowenoid papulosis, Photodiagn. Photodyn. Ther., 2007, 4, 88–93.

    Article  CAS  Google Scholar 

  66. P. Hillemanns, X. Wang, S. Staehle, W. Michels and C. Dannecker, Evaluation of different treatment modalities for vulvar intraepithelial neoplasia (VIN): CO2 laser vaporization, photodynamic therapy, excision and vulvectomy, Gynecol. Oncol., 2006, 100, 271–275.

    Article  PubMed  Google Scholar 

  67. U. Winters, S. Daayana, J. T. Lear, A. E. Tomlinson, E. Elkord, P. L Stern and H. C. Kitchener, Clinical and immunologic results of a phase II trial of sequential imiquimod and photodynamic therapy for vulval intraepithelial neoplasia, Clin. Cancer Res., 2008, 14, 5292–5299.

    Article  CAS  PubMed  Google Scholar 

  68. S. Michel, M. Landthaler and U. Hohenleutner, Recurrence of portwine stains after treatment with the flashlamp-pumped pulsed dye laser, Br. J. Dermatol., 2000, 143, 1230–1234.

    Article  CAS  PubMed  Google Scholar 

  69. M. Huikeshoven, P. H Koster, C. A de Borgie, J. F Beek, M. J van Gemert and C. M van der Horst, Redarkening of port-wine stains 10 years after pulsed-dye-laser treatment, N. Engl. J. Med., 2007, 356, 1235–1240.

    Article  CAS  PubMed  Google Scholar 

  70. T. L. Phung, D. A Oble, W. Jia, L. E. Benjamin, M. C. Mihm Jr. and J. S. Nelson, Can the wound healing response of human skin be modulated after laser treatment and the effects of exposure extended? Implications on the combined use of the pulsed dye laser and a topical angiogenesis inhibitor for treatment of port wine stain birthmarks, Lasers Surg. Med., 2008, 40, 1–5.

    Article  PubMed  PubMed Central  Google Scholar 

  71. C. J. Chang, Y. C. Hsiao, M. C. Mihm Jr. and J. S. Nelson, Pilot study examining the combined use of pulsed dye laser and topical imiquimod versus laser alone for treatment of port wine stain birthmarks, Lasers Surg. Med., 2008, 40, 605–610.

    Article  PubMed  PubMed Central  Google Scholar 

  72. A. Ferrario, K. F. von Tiehl, N. Rucker, M. A Schwarz, P. S. Gill and C. J. Gomer, Antiangiogenic treatment enhances photodynamic therapy responsiveness in a mouse mammary carcinoma, Cancer Res., 2000, 60, 4066–4069.

    CAS  PubMed  Google Scholar 

  73. A. Frimpong-Boateng, A. Bunse, F. Rüfer and J. Roider, Photodynamic therapy with intravitreal application of triamcinolone acetonide in agerelated macular degeneration: functional results in 54 patients, Acta Ophthalmol., 2009, 87, 183–187.

    Article  CAS  PubMed  Google Scholar 

  74. P. K. Kaiser, Registry of Visudyne AMD TherapyWriting Committee; D. S. Boyer, R. Garcia, Y. Hao, M. S. Hughes, N. M. Jabbour, P. K. Kaiser, W. Mieler, J. S. Slakter, M. Samuel, M. J. Tolentino, D. Roth, T. Sheidow and H. A. Strong, Verteporfin photodynamic therapy combined with intravitreal bevacizumab for neovascular age-related macular degeneration, Ophthalmology, 2009, 116, 747–755.

    PubMed  Google Scholar 

  75. M. Korbelik, I. Cecic, S. Merchant and J. Sun, Acute phase response induction by cancer treatment with photodynamic therapy, Int. J. Cancer, 2007, 122, 1411–1417.

    Article  CAS  Google Scholar 

  76. K. R. Suchin, A. J. Cucchiara, S. L. Gottleib, J. T. Wolfe, B. J. DeNardo, W. H. Macey, P. G. Bromley, C. C. Vittorio and A. H. Rook, Treatment of cutaneous T-cell lymphoma with combined immunomodulatory therapy: a 14-year experience at a single institution, Arch. Dermatol., 2002, 138, 1054–1060.

    PubMed  Google Scholar 

  77. S. K. Richardson, J. H. Lin, C. C. Vittorio, E. J. Kim, J. S. Yoon, J. Junkins-Hopkins and A. H. Rook, High clinical response rate with multimodality immunomodulatory therapy for Sézary syndrome, Clin. Lymphoma Myeloma, 2006, 7, 226–232.

    Article  CAS  PubMed  Google Scholar 

  78. M. F. Naylor, W. R. Chen, T. K. Teague, L. A. Perry and R. E. Nordquist, In situ photoimmunotherapy: a tumour-directed treatment for melanoma, Br. J. Dermatol., 2006, 155, 1287–1292.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zheng Huang.

Additional information

This article is published as part of a themed issue on immunological aspects and drug delivery technologies in PDT.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, XL., Wang, HW., Yuan, KH. et al. Combination of photodynamic therapy and immunomodulation for skin diseases—update of clinical aspects. Photochem Photobiol Sci 10, 704–711 (2011). https://doi.org/10.1039/c0pp00373e

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1039/c0pp00373e

Navigation