Dermatológia pre prax 2/2008

PHOTODYNAMIC THERAPY – OUR FIRST EXPIERENCE

Nonmelanoma skin cancers (NMSCs) are the most common malignancies. The link between the sun exposure, skin type and NMSC is established. Basalioma (BCC), m. Bowen and actinic keratosis (AK) are commonly removed by cryotherapy, electrodesiccation, laser, topical cytostatic therapy, etc. Photodynamic therapy (PDT) using skin photosensibilisation with delta aminolevulinic acid is new method for the treatment NMSCs. Photosensitizer is selectively accumulated in tumor cells. Selective interception of photosensitizer in malignic cells and following application of radiation at length 600 – 800 nm is leading to their destruction. 43 patients with diagnosis of superficial BCC and AK and one patient with nodular type of BCC were treated by PDT on our clinic during 8 months. Diagnosis was confirmed clinically and cytodiagnostically. Extension of pathological process was determined by fluorescent diagnostic (PDD). We assessed tolerability and outcome of PDT over application after treatment within control 1, 3 and 6 months. On the basis of our observation PDT is safe, it has good tolerance and easy ambulatory applied method for noninvasive treatment BCC and AK indicated first of all for lesions localized in areas where other methods are not applicable. PDT has excellent cosmetic outcome and enables simultaneous treatment of multiple tumors.

Keywords: photodynamic therapy, basal cell carcinoma, actinic keratosis, fluorescent diagnostics.