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Photodynamic Therapy for Malignant Skin Lesions

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European Handbook of Dermatological Treatments

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Abstract

Photodynamic therapy (PDT) is a form of phototherapy involving a photosensitizer, a light source, and tissue oxygen. Aminolevulinic acid (ALA) and its ester derivative methyl aminolevulinate (MAL) are commonly used photosensitizers acting as prodrugs for protoporphyrin IX (PpIX). PpIX accumulates in abnormal epidermis and upon subsequent exposure to and activation by the appropriate light source generates reactive oxygen species that selectively destroy diseased lesions. PDT has been established to be a safe and effective treatment for superficial skin cancers and premalignant skin lesions. Pain is the most severe adverse effect but can be effectively managed. Porphyria is an important contraindication. Common approved PDT protocols include Levulan 20% solution ALA-PDT activated with blue light and BF200-Ameluz 10% nanoemulsion ALA-PDT activated with red light for treatment of AK in the United States and superficial basal cell carcinoma and low-risk nodular basal cell carcinoma in Europe, and Metvix/Metvixia MAL-PDT for treatment of AK, Bowen’s disease, and basal cell carcinoma in Europe. Off-label, ALA-/MAL-PDT have been reported to treat invasive squamous cell carcinoma, cutaneous T-cell lymphoma, Kaposi’s sarcoma, Paget’s disease, and various benign inflammatory disorders and to prevent recurrence of squamous cell carcinoma in organ transplant recipients. Combination therapy of PDT with other treatment modalities such as cryotherapy, surgery, and field therapies is being explored with preliminary data suggesting improved efficacy, tolerability, and long-term results. In addition, PDT offers enhanced cosmetic outcome compared to cryotherapy or surgery. PDT can also be used for skin photorejuvenation.

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References

  • Alexiades-Armenakas M. Intense pulsed light-mediated photodynamic therapy. J Drugs Dermatol. 2005;4(5):657–8.

    PubMed  Google Scholar 

  • Alexiades-Armenakas MR, Geronemus RG. Laser-mediated photodynamic therapy of actinic keratoses. Arch Dermatol. 2003;139(10):1313–20.

    Article  PubMed  Google Scholar 

  • Alique-García S, Alique D, Company-Quiroga J, Sánchez A, Núñez AH, Borbujo J. Treatment of Bowen’s disease with photodynamic therapy. Observational study in 171 patients with 5-aminolaevulinic acid (BF-200 ALA) and methyl aminolaevulinate (MAL). Photodiagn Photodyn Ther. 2019;28:192–4. https://doi.org/10.1016/j.pdpdt.2019.08.011.

    Article  CAS  Google Scholar 

  • Allison RR, Downie GH, Cuenca R, Hu XH, Childs CJH, Sibata CH. Photosensitizers in clinical PDT. Photodiagn Photodyn Ther. 2004;1:27–42.

    Article  CAS  Google Scholar 

  • Alster TS, Surin-Lord SS. Photodynamic therapy: practical cosmetic applications. J Drugs Dermatol. 2006;5(8):764–8.

    PubMed  Google Scholar 

  • Anand S, Wilson C, Hasan T, Maytin EV. Vitamin D3 enhances the apoptotic response of epithelial tumors to aminolevulinate-based photodynamic therapy. Cancer Res. 2011;71(18):6040–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Anand S, Rollakanti KR, Horst RL, Hasan T, Maytin EV. Combination of oral vitamin D3 with photodynamic therapy enhances tumor cell death in a murine model of cutaneous squamous cell carcinoma. Photochem Photobiol. 2014;90(5):1126–35. https://doi.org/10.1111/php.12286.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Arits AH, Mosterd K, Essers BA, Spoorenberg E, Sommer A, De Rooij MJ. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma: a single blind, non-inferiority, randomised controlled trial. Lancet Oncol. 2013;14(7):647–54. Epub 2013 May 15.

    Article  CAS  PubMed  Google Scholar 

  • Bangash HK, Colegio OR. Management of non-melanoma skin cancer in immunocompromised solid organ transplant recipients. Curr Treat Options in Oncol. 2012;13(3):354–76.

    Article  Google Scholar 

  • Baron ED, Malbasa CL, Santo-Domingo D, Fu P, Miller JD, Hanneman KK, et al. Silicon phthalocyanine (Pc 4) photodynamic therapy is a safe modality for cutaneous neoplasms: results of a phase 1 clinical trial. Lasers Surg Med. 2010;42(10):728–35.

    Article  PubMed  PubMed Central  Google Scholar 

  • Basset-Séguin N, Ibbotson SH, Emtestam L, Tardstedt M, Morton C, Maroti M, et al. Topical methyl aminolaevulinate photodynamic therapy versus cryotherapy for superficial basal cell carcinoma: a 5 year randomized trial. Eur J Dermatol. 2008;18(5):547–53.

    PubMed  Google Scholar 

  • Bernstein ZP, Wilson BD, Oseroff AR, Jones CM, Dozier SE, Brooks JS, et al. Photofrin photodynamic therapy for treatment of AIDS-related cutaneous Kaposi’s sarcoma. AIDS. 1999;13(13):1697–704.

    Article  CAS  PubMed  Google Scholar 

  • Berroeta I, Clark C, Dawe RS, Ibbotson SH, Fleming CJ. A randomized study of minimal curettage followed by topical photodynamic therapy compared with surgical excision for low risk nodular BCC. Br J Dermatol. 2007;157(2):401–3.

    Article  CAS  PubMed  Google Scholar 

  • Braathen LR. Daylight photodynamic therapy in private practice in Switzerland: gain without pain. Acta Derm Venereol. 2012;92(6):652–3.

    Article  PubMed  Google Scholar 

  • Calzavara-Pinton PG, Venturini M, Sala R. Photodynamic therapy: update 2006. Part 1: Photochemistry and photobiology. J Eur Acad Dermatol Venereol. 2007;21(3):293–302.

    Article  CAS  PubMed  Google Scholar 

  • Calzavara-Pinton P, Venturini M, Sala R, Capezzera R, Parrinello G, Specchia C, et al. Methylaminolaevulinate-based photodynamic therapy of Bowen’s disease and squamous cell carcinoma. Br J Dermatol. 2008;159(1):137–44.

    Article  CAS  PubMed  Google Scholar 

  • Calzavara-Pinton PG, Rossi MT, Aronson E, Sala R. Italian Group For Photodynamic Therapy. A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 1: inflammatory and aesthetic indications. Photochem Photobiol Sci. 2013a;12(1):148–57.

    Article  CAS  PubMed  Google Scholar 

  • Calzavara-Pinton PG, Rossi MT, Sala R. Italian Group For Photodynamic Therapy. A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications. Photochem Photobiol Sci. 2013b;12(1):158–65.

    Article  CAS  PubMed  Google Scholar 

  • Chaves YN, Torezan LA, Niwa AB, Sanches Junior JA, Festa Neto C. Pain in photodynamic therapy: mechanism of action and management strategies. An Bras Dermatol. 2012;87(4):521–6.

    Article  PubMed  Google Scholar 

  • Choi SH, Kim KH, Song KH. Efficacy of ablative fractional laser-assisted photodynamic therapy for the treatment of actinic cheilitis: 12-month follow-up results of a prospective, randomized, comparative trial. Br J Dermatol. 2015;173(1):184–91.

    Article  CAS  PubMed  Google Scholar 

  • Christensen E, Skogvoll E, Viset T, Warloe T, Sundstrøm S. Photodynamic therapy with 5-aminolaevulinic acid, dimethylsulfoxide and curettage in basal cell carcinoma: a 6-year clinical and histological follow-up. J Eur Acad Dermatol Venereol. 2009;23(1):58–66.

    Article  CAS  PubMed  Google Scholar 

  • Christensen E, Mørk C, Skogvoll E. High and sustained efficacy after two sessions of topical 5-aminolaevulinic acid photodynamic therapy for basal cell carcinoma: a prospective, clinical and histological 10-year follow-up study. Br J Dermatol. 2012;166(6):1342–8.

    Article  CAS  PubMed  Google Scholar 

  • Clark C, Bryden A, Dawe R, Moseley H, Ferguson J, Ibbotson SH. Topical 5-aminolaevulinic acid photodynamic therapy for cutaneous lesions: outcome and comparison of light sources. Photodermatol Photoimmunol Photomed. 2003;19(3):134–41.

    Article  CAS  PubMed  Google Scholar 

  • Cox N, Eedy D, Morton C. Therapy Guidelines Audit Subcommittee, British Association of Dermatologists. Guidelines for management of Bowen’s disease: 2006 update. Br J Dermatol. 2007;156(1):11–21.

    Article  CAS  PubMed  Google Scholar 

  • Cunningham TJ, Tabacchi M, Eliane JP, Tuchayi SM, Manivasagam S, Mirzaalian H, et al. Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy. J Clin Invest. 2017;127(1):106–16.

    Article  PubMed  Google Scholar 

  • Debu A, Girard C, Kluger N, Guillot B, Dereure O. Topical methyl aminolaevulinate photodynamic therapy in erosive facial mycosis fungoides. Br J Dermatol. 2010;163(4):884–5.

    Google Scholar 

  • Dijkstra AT, Majoie IM, van Dongen JW, van Weelden H, van Vloten WA. Photodynamic therapy with violet light and topical 6-aminolaevulinic acid in the treatment of actinic keratosis, Bowen’s disease and basal cell carcinoma. J Eur Acad Dermatol Venereol. 2001;15(6):550–4.

    Article  CAS  PubMed  Google Scholar 

  • Dirschka T, Radny P, Dominicus R, Mensing H, Bruning H, Jenne L, et al. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratoses: results of a multicentre, randomized, observer-blind phase III study in comparison with registered methyl-5-aminolaevulinate cream and placebo. Br J Dermatol. 2012;166(1):137–46.

    Article  CAS  PubMed  Google Scholar 

  • Dirschka T, Radny P, Dominicus R, Mensing H, Brüning H, Jenne L, et al. Long-term (6 and 12 months) follow-up of two prospective, randomized, controlled phase III trials of photodynamic therapy with BF-200 ALA and methyl aminolaevulinate for the treatment of actinic keratosis. Br J Dermatol. 2013;168(4):825–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dirschka T, Ekanayake-Bohlig S, Dominicus R, Aschoff R, Herrera-Ceballos E, Botella-Estrada R, et al. A randomized, intraindividual, non-inferiority, Phase III study comparing daylight photodynamic therapy with BF-200 ALA gel and MAL cream for the treatment of actinic keratosis. J Eur Acad Dermatol Venereol. 2019;33(2):288–97.

    Article  CAS  PubMed  Google Scholar 

  • Dougherty TJ. Photosensitizers: therapy and detection of malignant tumors. Photochem Photobiol. 1987;45(6):879–89.

    Article  CAS  PubMed  Google Scholar 

  • Dougherty TJ, Kaufman JE, Goldfarb A, Weishaupt KR, Boyle D, Mittleman A. Photoradiation therapy for the treatment of malignant tumors. Cancer Res. 1978;38(8):2628–35.

    CAS  PubMed  Google Scholar 

  • Dover J, Bhatia AC, Stewart B, Arndt KA. Topical 5-aminolevulinic acid combined with intense pulsed light in the treatment of photoaging. Arch Dermatol. 2005;141(10):1247–52.

    Article  PubMed  Google Scholar 

  • Edstrom DW, Porwit A, Ros AM. Photodynamic therapy with topical 5-aminolevulinic acid for mycosis fungoides: clinical and histological response. Acta Derm Venereol. 2001;81(3):184–8.

    Article  CAS  PubMed  Google Scholar 

  • Ericson MB, Sandberg C, Stenquist B, Gudmundson F, Karlsson M, Ros AM, et al. Photodynamic therapy of actinic keratosis at varying fluence rates: assessment of photobleaching, pain and primary clinical outcome. Br J Dermatol. 2004;151(6):1204–12.

    Article  CAS  PubMed  Google Scholar 

  • Fernández-Guarino M, Harto A, Pérez-García B, Royuela A, Jaén P. Six years of experience in photodynamic therapy for Basal cell carcinoma: results and fluorescence diagnosis from 191 lesions. J Skin Cancer. 2014;2014:849248.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fink C, Uhlmann L, Enk A, Gholam P. Pain management in photodynamic therapy using a nitrous oxide/oxygen mixture: a prospective, within-patient, controlled clinical trial. J Eur Acad Dermatol Venereol. 2017;31(1):70–4.

    Article  CAS  PubMed  Google Scholar 

  • Foley P, Freeman M, Menter A, Siller G, El-Azhary RA, Gebauer K, et al. Photodynamic therapy with methyl amninolevulinate for primary nodular basal cell carcinoma: results of two randomized studies. Int J Dermatol. 2009;48(11):1236–45.

    Article  CAS  PubMed  Google Scholar 

  • Friedmann DP, Goldman MP, Fabi SG, Guiha I. The effect of multiple sequential light sources to activate aminolevulinic Acid in the treatment of actinic keratoses: a retrospective study. J Clin Aesthet Dermatol. 2014;7(9):20–5.

    PubMed  PubMed Central  Google Scholar 

  • Girard C, Debu A, Bessis D, Blatiere V, Dereure O, Guillot B. Treatment of Gorlin syndrome (nevoid basal cell carcinoma syndrome) with methylaminolevulinate photodynamic therapy in seven patients, including two children: interest of tumescent anesthesia for pain control in children. J Eur Acad Dermatol Venereol. 2013;27(2):e171–5.

    Article  CAS  PubMed  Google Scholar 

  • Gold M, Bradshaw VL, Boring MM, Bridges TM, Biron JA. Split-face comparison of photodynamic therapy with 5-aminolevulinic acid and intense pulsed light versus intense pulsed light alone for photodamage. Dermatol Surg. 2006;32(6):795–801.

    CAS  PubMed  Google Scholar 

  • Haak CS, Togsverd-Bo K, Thaysen-Petersen D, Wulf HC, Paasch U, Anderson RR, et al. Fractional laser-mediated photodynamic therapy of high-risk basal cell carcinomas--a randomized clinical trial. Br J Dermatol. 2015;172(1):215–22.

    Article  CAS  PubMed  Google Scholar 

  • de Haas ER, Sterenborg HJ, Neumann HA, Robinson DJ. Response of Bowen disease to ALA-PDT using a single and a 2-fold illumination scheme. Arch Dermatol. 2007;143(2):264–5.

    PubMed  Google Scholar 

  • de Haas ER, de Vijlder HC, Sterenborg HJ, Neumann HA, Robinson DJ. Fractionated aminolevulinic acid-photodynamic therapy provides additional evidence for the use of PDT for non-melanoma skin cancer. J Eur Acad Dermatol Venereol. 2008;22(4):426–30.

    Article  PubMed  Google Scholar 

  • Haddad A, Santos ID, Gragnani A, Ferreira LM. The effect of increasing fluence on the treatment of actinic keratosis and photodamage by photodynamic therapy with 5-aminolevulinic acid and intense pulsed light. Photomed Laser Surg. 2011;29(6):427–32.

    Article  CAS  PubMed  Google Scholar 

  • Hauschild A, Stockfleth E, Popp G, et al. Optimization of photodynamic therapy with a novel self-adhesive 5-aminolaevulinic acid patch: results of two randomized controlled phase III studies. Br J Dermatol. 2009;160(5):1066–74.

    Article  CAS  PubMed  Google Scholar 

  • Hebeda KM, Huizing MT, Brouwer PA, van der Meulen FW, Hulsebosch HJ, Reiss P, et al. Photodynamic therapy in AIDS-related cutaneous Kaposi’s sarcoma. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;10(1):61–70.

    Article  CAS  PubMed  Google Scholar 

  • Jesionek A, Von Tappeiner H. On the treatment of skin cancers with fluorescent substances. Arch Klin Med. 1905;82:223–7.

    Google Scholar 

  • Jodlbauer A, Von Tappeiner H. On the participation of oxygen in the photodynamic effect of fluorescent substances. München Med Wochenschr. 1904;52:1139–41.

    Google Scholar 

  • Kaminska EC, Tsoukas MM. Combining field therapies for actinic keratoses: novel approaches that intensify photodynamic therapy. Skinmed. 2013;11(1):54–8.

    PubMed  Google Scholar 

  • Kennedy JC, Pottier RH, Pross DC. Photodynamic therapy with endogenous protoporphyrin IX: basic principles and present clinical experience. J Photochem Photobiol B. 1990;6(1–2):143–8.

    Article  CAS  PubMed  Google Scholar 

  • Kick G, Messer G, Plewig G. Historische entwicklung der photodynamischen therapie. Hautarzt. 1996;47(8):644–9. German.

    Article  CAS  PubMed  Google Scholar 

  • Ko DY, Jeon SY, Kim KH, Song KH. Fractional erbium: YAG laser-assisted photodynamic therapy for facial actinic keratoses: a randomized, comparative, prospective study. J Eur Acad Dermatol Venereol. 2014;28(11):1529–39.

    Article  CAS  PubMed  Google Scholar 

  • Kohl E, Torezan LAR, Landthaler M, Szeimies RM. Aesthetic effects of topical photodynamic therapy. J Eur Acad Dermatol Venereol. 2010;24(11):1261–9.

    Article  CAS  PubMed  Google Scholar 

  • Lam M, Lee Y, Deng M, Hsia AH, Morrissey KA, Yan C, et al. Photodynamic therapy with the silicon phthalocyanine pc 4 induces apoptosis in mycosis fungoides and sezary syndrome. Adv Hematol. 2010;2010:896161.

    PubMed  PubMed Central  Google Scholar 

  • Lecomte F, Thecua E, Ziane L, Deleporte P, Duhamel A, Maire C, et al. Photodynamic therapy using a new painless light-emitting fabrics device in the treatment of extramammary paget disease of the vulva (the PAGETEX Study): protocol for an interventional efficacy and safety trial. JMIR Res Protoc. 2019;8(12):e15026.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lippert J, Smucler R, Vlk M. Fractional carbon dioxide laser improves nodular basal cell carcinoma treatment with photodynamic therapy with methyl 5-aminolevulinate. Dermatol Surg. 2013;39:1202–8.

    Article  CAS  PubMed  Google Scholar 

  • Lipson RL, Baldes EJ. The photodynamic properties of a particular hematoporphyrin derivative. Arch Dermatol. 1960;82:508–16.

    Article  CAS  PubMed  Google Scholar 

  • Lipson RL, Baldes EJ, Olsen AM. The use of a derivative of hematoporphyrin in tumor detection. J Natl Cancer Inst. 1961;26:1–11.

    CAS  PubMed  Google Scholar 

  • Loncaster J, Swindell R, Slevin F, Sheridan L, Allan D, Allan E. Efficacy of photodynamic therapy as a treatment for Gorlin syndrome-related basal cell carcinomas. Clin Oncol (R Coll Radiol). 2009;21(6):502–8.

    Article  CAS  PubMed  Google Scholar 

  • Maytin EV, Anand S, Riha M, Lohser S, Tellez A, Ishak R, et al. 5-Fluorouracil enhances protoporphyrin IX accumulation and lesion clearance during photodynamic therapy of actinic keratoses: a mechanism-based clinical trial. Clin Cancer Res. 2018;24(13):3026–35.

    Article  CAS  PubMed  Google Scholar 

  • Mikasa K, Watananabe D, Kondo C, Kobayashi M, Nakaseko H, Yokoo K, et al. 5-Aminolevulinic acid-based photodynamic therapy for the treatment of two patients with extramammary Paget’s disease. J Dermatol. 2005;32(2):97–101.

    Article  CAS  PubMed  Google Scholar 

  • Mori M, Campolmi P, Mavilia L, Rossi R, Cappugi P, Pimpinelli N. Topical photodynamic therapy for primary cutaneous B-cell lymphoma: a pilot study. J Am Acad Dermatol. 2006;54(3):524–6.

    Article  PubMed  Google Scholar 

  • Morton CA, Braathen LR. Daylight photodynamic therapy for actinic keratoses. Am J Clin Dermatol. 2018;19(5):647–56. https://doi.org/10.1007/s40257-018-0360-y.

    Article  PubMed  Google Scholar 

  • Morton CA, MacKie RM, Whitehurts C, Moore JV, McColl JH. Photodynamic therapy for basal cell carcinoma- effect of tumour thickness and duration of photosensitiser application on response. Arch Dermatol. 1998;134(2):248–9.

    Article  CAS  PubMed  Google Scholar 

  • Morton C, Campbell S, Gupta G, Keohane S, Lear J, Zaki I, et al. Intraindividual, right-left comparison of topical methyl aminolaevulinate-photodynamic therapy and cryotherapy in subjects with actinic keratoses: a multicentre, randomized controlled study. Br J Dermatol. 2006a;155(5):1029–36.

    Article  CAS  PubMed  Google Scholar 

  • Morton CA, Horn M, Leman J, Tack B, Bedane C, Tjioe M, et al. A randomized, placebo-controlled, European study comparing MAL-PDT with cryotherapy and 5-fluorouracil in subjects with Bowen’s disease. Arch Dermatol. 2006b;142(6):729–35.

    CAS  PubMed  Google Scholar 

  • Morton CA, McKenna KE, Rhodes LE. British Association of Dermatologists Therapy Guidelines and Audit Subcommittee and the British Photodermatology Group. Guidelines for topical photodynamic therapy: update. Br J Dermatol. 2008;159(6):1245–66.

    Article  CAS  PubMed  Google Scholar 

  • Morton CA, Szeimies RM, Sidoroff A, Braathen LR. European guidelines for topical photodynamic therapy. Part 1: treatment delivery and current indications – actinic keratoses, Bowen’s disease, basal cell carcinoma. J Eur Acad Dermatol Venereol. 2013a;27(5):536–44.

    Article  CAS  PubMed  Google Scholar 

  • Morton CA, Szeimies RM, Sidoroff A, Braathen LR. European guidelines for topical photodynamic therapy. Part 2: emerging indications – field cancerization, photorejuvenation and inflammatory/infective dermatoses. J Eur Acad Dermatol Venereol. 2013b;27(6):672–9.

    Article  CAS  PubMed  Google Scholar 

  • Mosterd K, Thissen MRTM, Nelemans P, Kelleners-Smeets NW, Janssen RL, Broekhof KG, et al. Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial. Br J Dermatol. 2008;159(4):864–70.

    Article  CAS  PubMed  Google Scholar 

  • Nester MS, Gold MH, Kauvar AN, Taub AF, Geronemus RG, Ritvo EC, et al. The use of photodynamic therapy in dermatology: results of a consensus conference. J Drugs Dermatol. 2006;5(2):140–54.

    Google Scholar 

  • Nie Z. Is photodynamic therapy a solution for keloid? G Ital Dermatol Venereol. 2011;146(6):463–72.

    CAS  PubMed  Google Scholar 

  • Nissen CV, Heerfordt IM, Wiegell SR, Mikkelsen CS, Wulf HC. Pretreatment with 5-fluorouracil cream enhances the efficacy of daylight-mediated photodynamic therapy for actinic keratosis. Acta Derm Venereol. 2017;97(5):617–21.

    Article  CAS  PubMed  Google Scholar 

  • Orenstin A, Kostenich G, Malik Z. The kinetics of protoporphyrin fluorescence during ALA-PDT in human malignant skin tumors. Cancer Lett. 1997;120(2):229–34.

    Article  Google Scholar 

  • Ozog DM, Rkein AM, Fabi SG, Gold MH, Goldman MP, Lowe NJ, et al. Photodynamic therapy: a clinical consensus guide. Dermatol Surg. 2016;42(7):804–27.

    Article  CAS  PubMed  Google Scholar 

  • Pariser DM, Houlihan A, Ferdon MB, Berg JE. Randomized vehicle-controlled study of short drug incubation aminolevulinic acid photodynamic therapy for actinic keratoses of the face or scalp. Dermatol Surg. 2016;42(3):296–304.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pauwels C, Mazereeuw-Hautier J, Basset-Seguin N, Livideanu C, Viraben R, Paul C, et al. Topical methyl aminolevulinate photodynamic therapy for management of basal cell carcinomas in patients with basal cell nevus syndrome improves patient’s satisfaction and reduces the need for surgical procedures. J Eur Acad Dematol Venereol. 2011;25(7):861–4.

    Article  CAS  Google Scholar 

  • Peng Q, Warloe T, Berg K, Moan J, Kongshaug M, Giercksky KE, et al. 5-Aminolevulinic acid-based photodynamic therapy. Clin Res Fut Chall Cancer. 1997;79(12):2282–308.

    CAS  Google Scholar 

  • Peng Q, Soler AM, Warloe T, Nesland JM, Gierchsky KE. Selective distribution of porphyrins in thick basal cell carcinoma after topical application of methyl 5-aminolevulinate. J Photochem Photobiol B. 2001;62(3):140–5.

    Article  CAS  PubMed  Google Scholar 

  • Philipp-Dormston WG. Photodynamic therapy for aesthetic-cosmetic indications. G Ital Dermatol Venereol. 2018;153(6):817–26.

    Article  PubMed  Google Scholar 

  • Piacquadio DJ, Chen DM, Farber HF, Fowler JF Jr, Glazer SD, Goodman JJ, et al. Photodynamic therapy with aminolevulinic acid topical solution and visible blue light in the treatment of multiple actinic keratoses of the face and scalp: investigator-blinded phase 3 multicenter trials. Arch Dermatol. 2004;140(1):41–6.

    Article  CAS  PubMed  Google Scholar 

  • Raab O. On the effect of fluorescent substances on infusoria. Z Biol. 1900;39:524–6.

    CAS  Google Scholar 

  • Rapagliesi F, Fontanelli R, Rossi G, Ditto A, Solima E, Hanozet F, et al. Photodynamic therapy using a methyl ester of 5-aminolaevulinic acid in recurrent Paget’s disease of the vulva: a pilot study. Gynecol Oncol. 2006;103(2):581–6.

    Article  Google Scholar 

  • Reinhold U, Dirschka T, Ostendorf R, Aschoff R, Berking C, Philipp-Dormston WG, et al. A randomized, double-blind, phase III, multicentre study to evaluate the safety and efficacy of BF-200 ALA (Ameluz(®)) vs. placebo in the field-directed treatment of mild-to-moderate actinic keratosis with photodynamic therapy (PDT) when using the BF-RhodoLED(®) lamp. Br J Dermatol. 2016;175(4):696–705.

    Article  CAS  PubMed  Google Scholar 

  • Rhodes LE, de Rie M, Enstrom Y, Groves R, Morken T, Goulden V, et al. Photodynamic therapy using topical methyl aminolevulinate vs surgery for nodular basal cell carcinoma: results of a multicenter randomized prospective trial. Arch Dermatol. 2004;140(1):12–23.

    Article  Google Scholar 

  • Rhodes LE, de Rie MA, Leifsdottir R, Yu RC, Bachmann I, Goulden V, et al. Five year follow up of a randomized prospective trial of topical methyl aminolevulinate-photodynamic therapy versus surgery for nodular basal cell carcinoma. Arch Dermatol. 2007;143(9):1131–6.

    Article  CAS  PubMed  Google Scholar 

  • Rollakanti KR, Anand S, Davis SC, Pogue BW, Maytin EV. Noninvasive optical imaging of UV-induced squamous cell carcinoma in murine skin: studies of early tumor development and vitamin D enhancement of protoporphyrin IX production. Photochem Photobiol. 2015;91(6):1469–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rook AH, Wood GS, Duvic M, Vonderheid EC, Tobia A, Cabana B. A phase II placebo-controlled study of photodynamic therapy with topical hypericin and visible light irradiation in the treatment of cutaneous T-cell lymphoma and psoriasis. J Am Acad Dermatol. 2010;63(6):984–90.

    Article  CAS  PubMed  Google Scholar 

  • Roozeboom MH, Aardoom MA, Nelemans PJ, Thissen MR, Kelleners-Smeets NW, Kuijpers DI, et al. Fractionated 5-aminolevulinic acid photodynamic therapy after partial debulking versus surgical excision for nodular basal cell carcinoma: a randomized controlled trial with at least 5-year follow-up. J Am Acad Dermatol. 2013;69:280–7.

    Article  CAS  PubMed  Google Scholar 

  • Rose RF, Stables GI. Topical photodynamic therapy in the treatment of hidradenitis suppurativa. Photodiagn Photodyn Ther. 2008;5(3):171–5.

    Article  CAS  Google Scholar 

  • Rosenberg AR, Tabacchi M, Ngo KH, Wallendorf M, Rosman IS, Cornelius LA, et al. Skin cancer precursor immunotherapy for squamous cell carcinoma prevention. JCI Insight. 2019;4(6):e125476.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ross K, Cherpelis B, Lien M, Fenske N. Spotlighting the role of photodynamic therapy in cutaneous malignancy: an update and expansion. Dermatol Surg. 2013;39(12):1733–44.

    Article  CAS  PubMed  Google Scholar 

  • Ruiz-Rodriguez R, Lopez L, Candelas D, Zelickson B. Enhanced efficacy photodynamic therapy after fractional resurfacing: fractional photodynamic rejuvenation. J Drugs Dermatol. 2007;6(8):818–20.

    PubMed  Google Scholar 

  • Ruiz-Rodriguez R, Lopez L, Candelas D, Pedraz J. Photorejuvenation using topical 5-methyl aminolevulinate and red light. J Drugs Dermatol. 2008;7(7):633–7.

    PubMed  Google Scholar 

  • Sanclemente G, Medina L, Villa J-F, Barrera L-M, Garcia H-I. A prospective split-face double-blind randomized placebo-controlled trial to assess the efficacy of methyl aminolevulinate + red light in patients with facial photodamage. J Eur Acad Dermatol Venereol. 2011;25(1):49–58.

    Article  CAS  PubMed  Google Scholar 

  • Shieh S, Dee AS, Cheney RT, Frawley NP, Zeitouni NC, Oseroff AR. Photodynamic therapy for the treatment of extramammary Paget’s disease. Br J Dermatol. 2002;146(6):1000–5.

    Article  CAS  PubMed  Google Scholar 

  • Shokrollahi K, Javed M, Aeuyung K, Ghattaura A, Whitaker IS, O’Leary B, et al. Combined carbon dioxide laser with photodynamic therapy for nodular and superficial basal cell carcinoma. Ann Plast Surg. 2014;73(5):552–8.

    Article  CAS  PubMed  Google Scholar 

  • Szeimies RM, Calzavara-Pinton P, Karrer S, Ortel B, Landthaler M. Topical photodynamic therapy in dermatology. J Photochem Photobiol B. 1996;36(2):213–9.

    Article  CAS  PubMed  Google Scholar 

  • Szeimies R, Ibbotson S, Murrell DF, Rubel D, Frambach Y, de Berker D. A clinical study comparing methyl aminolevulinate photodynamic therapy and surgery in small superficial basal cell carcinoma (8–20mm), with a 12-month follow-up. J Eur Acad Dermatol Venereol. 2008;22(11):1302–11.

    Article  CAS  PubMed  Google Scholar 

  • Szeimies R-M, Lischner S, Philipp-Dormston W, Walker T, Hiepe-Wegener D, Feiser K, et al. Photodynamic therapy for skin rejuvenation: treatment options—results of a consensus conference of an expert group for aesthetic photodynamic therapy. J Dtsch Dermatol Ges. 2013;11:632–6.

    PubMed  Google Scholar 

  • Takeda H, Kaneko T, Harada K, Matsuzaki Y, Nakano H, Hanada K. Successful treatment of lymphadenosis benigna cutis with topical photodynamic therapy with delta-aminolevulinic acid. Dermatology. 2005;211(3):264–6.

    Article  CAS  PubMed  Google Scholar 

  • Tardivo JP, Del Giglio A, Paschoal LH, Baptista MS. New photodynamic therapy protocol to treat AIDS-related Kaposi’s sarcoma. Photomed Laser Surg. 2006;24(4):528–31.

    Article  PubMed  Google Scholar 

  • Tarstedt M, Rosdahl I, Berne B, Wennberg AM. A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix)-PDT in actinic keratosis of the face and scalp. Acta Derm Venereol. 2005;85(5):424–8.

    Article  CAS  PubMed  Google Scholar 

  • Tarstedt M, Gillstedt M, Wennberg Larkö AM, Paoli J. Aminolevulinic acid and methyl aminolevulinate equally effective in topical photodynamic therapy for non-melanoma skin cancers. J Eur Acad Dermatol Venereol. 2016;30(3):420–3.

    Article  CAS  PubMed  Google Scholar 

  • Telfer NR, Colver GB, Morton CA. British Association of Dermatologist. Guidelines for the management of basal cell carcinoma. Br J Dermatol. 2008;159(1):35–48.

    Article  CAS  PubMed  Google Scholar 

  • Togsverd-Bo K, Idorn LW, Philipsen PA, Wulf HC, Hædersdal M. Protoporphyrin IX formation and photobleaching in different layers of normal human skin: methyl- and hexylaminolevulinate and different light sources. Exp Dermatol. 2012;21(10):745–50.

    Article  CAS  PubMed  Google Scholar 

  • Togsverd-Bo K, Lei U, Erlendsson AM, Taudorf EH, Philipsen PA, Wulf HC, et al. Combination of ablative fractional laser and daylight-mediated photodynamic therapy for actinic keratosis in organ transplant recipients - a randomized controlled trial. Br J Dermatol. 2015;172(2):467–74.

    Article  CAS  PubMed  Google Scholar 

  • Torezan L, Grinblat B, Haedersdal M, Valente N, Festa-Neto C, Szeimies RM. A randomized split-scalp study comparing calcipotriol-assisted methyl aminolaevulinate photodynamic therapy (MAL-PDT) with conventional MAL-PDT for the treatment of actinic keratosis. Br J Dermatol. 2018;179(4):829–35.

    Article  CAS  PubMed  Google Scholar 

  • Touma D, Yaar M, Whitehead S, Konnikov N, Gilchrest BA. A trial of short incubation, broad-area photodynamic therapy for facial actinic keratosis and diffuse photodamage. Arch Dermatol. 2004;140(1):33–40.

    Article  CAS  PubMed  Google Scholar 

  • Truchuelo M, Fernández-Guarino M, Fleta B, Alcántara J, Jaén P. Effectiveness of photodynamic therapy in Bowen’s disease: an observational and descriptive study in 51 lesions. J Eur Acad Dermatol Venereol. 2012;26(7):868–74.

    Article  CAS  PubMed  Google Scholar 

  • Varma S, Wilson H, Kurwa HA, Gambles B, Charman C, Pearse AD. Bowen’s disease, solar keratoses and superficial basal cell carcinomas treated by photodynamic therapy using a large-field incoherent light source. Br J Dermatol. 2001;144(3):567–74.

    Article  CAS  PubMed  Google Scholar 

  • Vinciullo C, Elliott T, Francis D, Gebauer K, Spelman L, Nguyen R, et al. Photodynamic therapy with topical methyl aminolaevulinate for difficult-to-treat basal cell carcinoma. Br J Dermatol. 2005;152(4):765–72.

    Article  CAS  PubMed  Google Scholar 

  • Wang I, Bendsoe N, Klinteberg CA, Enejder AM, Andersson-Engels S, Svanberg S. Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase III clinical trial. Br J Dermatol. 2001;144(4):832–40.

    Article  CAS  PubMed  Google Scholar 

  • Wiegell SR, Wulf HC, Szeimies RM, Basset-Seguin N, Bissonnette R, Gerritsen MJ, et al. Daylight photodynamic therapy for actinic keratosis: an international consensus: international Society for Photodynamic Therapy in Dermatology. J Eur Acad Dermatol Venereol. 2012;26(6):673–9.

    Article  CAS  PubMed  Google Scholar 

  • Willey A, Mehta S, Lee PK. Reduction in the incidence of squamous cell carcinoma in solid organ transplant recipients treated with cyclic photodynamic therapy. Dermatol Surg. 2010;36(5):652–8.

    Article  CAS  PubMed  Google Scholar 

  • Wolf P, Rieger E, Kerl H. Topical photodynamic therapy with endogenous porphyrins after application of 5-aminolevulinic acid. An alternative treatment modality for solar keratoses, superficial squamous cell carcinomas, and basal cell carcinomas? J Am Acad Dermatol. 1993;28(1):17–21.

    Article  CAS  PubMed  Google Scholar 

  • Zane C, Venturini M, Sala R, Calzavara-Pinton P. Photodynamic therapy with methylaminolevulinate as a valuable treatment option for unilesional cutaneous T-cell lymphoma. Photodermatol Photoimmunol Photomed. 2006;22(5):254–8.

    Article  PubMed  Google Scholar 

  • Zawislak AA, McCarron PA, McCluggage WG, Price JH, Donnelly RF, McClelland HR, et al. Successful photodynamic therapy of vulval Paget’s disease using a novel patch-based delivery system containing 5-aminolevulinic acid. Br J Obstet Gynaecol. 2004;111(10):1143–5.

    Article  CAS  Google Scholar 

  • Zeitouni NC, Paquette AD, Housel JP, Shi Y, Wilding GE, Foster TH, et al. A retrospective review of pain control by a two-step irradiance schedule during topical ALA-photodynamic therapy of non-melanoma skin cancer. Lasers Surg Med. 2013;45(2):89–94.

    Article  PubMed  PubMed Central  Google Scholar 

Further Reading

  • Fantini F, Greco A, Del Giovane C, Cesinaro AM, Venturini M, Zane C, et al. Photodynamic therapy for basal cell carcinoma: clinical and pathological determinants of response. J Eur Acad Dermatol Venereol. 2011;25(8):896–901.

    Article  CAS  PubMed  Google Scholar 

  • Kaufmann R, Spelman L, Weightman W, Reifenberger J, Szeimies RM, Verhaeghe E, et al. Multicentre intraindividual randomized trial of topical methyl aminolaevulinate–photodynamic therapy vs. cryotherapy for multiple actinic keratoses on the extremities. Br J Dermatol. 2008;158(5):994–9.

    Article  CAS  PubMed  Google Scholar 

  • Tschen EH, Wong DS, Pariser DM, Dunlap FE, Houlihan A, Ferdon MB. The 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(6):1262–9.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA

    Carolina Puyana, Ryan Bunney & Maria M. Tsoukas

  2. Section of Dermatology, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Edidiong Celestine Ntuen Kaminska & Susan Pei

  3. Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

    Susan Pei

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  1. Carolina Puyana
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  2. Ryan Bunney
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  3. Edidiong Celestine Ntuen Kaminska
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  4. Susan Pei
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  5. Maria M. Tsoukas
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Correspondence to Maria M. Tsoukas .

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Editors and Affiliations

  1. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Andreas D. Katsambas

  2. Research Center CSRMR, Marconi University, Rome, Roma, Italy

    Torello M. Lotti

  3. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Clio Dessinioti

  4. Dermatoloy Unit, Livorno Hospital, Livorno, Italy

    Angelo Massimiliano D'Erme

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Puyana, C., Bunney, R., Kaminska, E.C.N., Pei, S., Tsoukas, M.M. (2023). Photodynamic Therapy for Malignant Skin Lesions. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_126

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