Photodynamic therapy with systemic administration of photosensitizers in dermatology.

We have reviewed the results of clinical investigations into the use of photodynamic therapy (PDT) with intravenous injection of hematoporphyrin derivative (HpD), Photofrin (PF) and Sn-protoporphyrin (Sn-Pp) or oral administration of delta-aminolevulinic acid in the treatment of skin cancers and/or psoriasis. Bowen's disease was highly responsive, provided that adequate light and HpD or PF doses were delivered. In contrast, poor results were shown for squamous cell carcinoma, and the rates of complete response of basal cell carcinoma ranged between 0% and 100%. Treatment failures could be related to the delivery of low drug and/or light doses, but differences in the thickness and pigmentation of the treated lesions may play a relevant role. Good palliation was almost always achieved in patients affected by primary and secondary breast carcinomas, although complete eradication of tumors was very rare. PDT is a very promising treatment modality for both Mediterranean and HIV-related Kaposi's sarcoma, because it appears to be effective, can be repeated and is not associated with immunosuppressive activity or significant systemic toxicity. PDT of psoriasis with low doses of Sn-Pp, HpD or PF plus UVA light and PF plus 630 nm light proved to be effective and was associated with mild, dose-related and reversible photosensitivity.

[1]  M. Berns,et al.  LOW-DOSE PHOTOFRIN II PHOTODYNAMIC THERAPY OF PSORIASIS , 1991 .

[2]  P. Speight,et al.  Photodynamic therapy of oral cancer: photosensitisation with systemic aminolaevulinic acid , 1993, The Lancet.

[3]  Michele T. Cooper,et al.  Photodynamic therapy for the treatment of basal cell carcinoma. , 1992, Archives of dermatology.

[4]  J. McCaughan.  OVERVIEW OF EXPERIENCES WITH PHOTODYNAMIC THERAPY FOR MALIGNANCY IN 192 PATIENTS , 1987, Photochemistry and photobiology.

[5]  H Lui,et al.  Photodynamic therapy in dermatology: recent developments. , 1993, Dermatologic clinics.

[6]  R. Carroll,et al.  Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient follow-up. , 1989, The Journal of dermatologic surgery and oncology.

[7]  P. Smith,et al.  Photodynamic therapy for chest wall recurrence in breast cancer. , 1991, International journal of radiation oncology, biology, physics.

[8]  M. Waner,et al.  Photodynamic Therapy for Multiple Skin Cancers , 1988, Plastic and reconstructive surgery.

[9]  W. Hicks,et al.  Photodynamic therapy for cutaneous and subcutaneous malignant neoplasms. , 1989, Archives of surgery.

[10]  M. Berns,et al.  Response of psoriasis to red laser light (630 nm) following systemic injection of hematoporphyrin derivative , 1984, Lasers in surgery and medicine.

[11]  R. Anderson,et al.  Hematoporphyrin derivative photoradiation therapy in managing nevoid basal-cell carcinoma syndrome. A preliminary report. , 1984 .

[12]  M. Ashby,et al.  Treatment of nonmelanoma skin cancer at a large australian center , 1990, Cancer.

[13]  C J Gomer,et al.  Molecular, cellular, and tissue responses following photodynamic therapy , 1988, Lasers in surgery and medicine.

[14]  B. Henderson,et al.  DRUG and LIGHT DOSE DEPENDENCE OF PHOTODYNAMIC THERAPY: A STUDY OF TUMOR and NORMAL TISSUE RESPONSE , 1987, Photochemistry and photobiology.

[15]  R. Straight,et al.  Systemic immunosuppression induced by peritoneal photodynamic therapy. , 1988, American journal of obstetrics and gynecology.

[16]  B. Angelin,et al.  TIN-PROTOPORPHYRIN AND LONG WAVE LENGTH ULTRAVIOLET LIGHT IN TREATMENT OF PSORIASIS , 1989, The Lancet.

[17]  T. Mang,et al.  Photodynamic therapy in the treatment of Bowen's disease. , 1992, Journal of the American Academy of Dermatology.

[18]  J Moan,et al.  PHOTOBLEACHING OF PORPHYRINS USED IN PHOTODYNAMIC THERAPY AND IMPLICATIONS FOR THERAPY , 1987, Photochemistry and photobiology.

[19]  P. Robinson,et al.  Photodynamic therapy: a better treatment for widespread Bowen's disease , 1988, The British journal of dermatology.

[20]  M. Waner,et al.  Squamous cell carcinoma of the lower lip involving a large cutaneous surface. Photodynamic therapy as an alternative therapy. , 1990, Archives of dermatology.

[21]  T. Dougherty,et al.  Photoradiation therapy for cutaneous and subcutaneous malignancies. , 1981, The Journal of investigative dermatology.

[22]  G. Jori.  PHOTOSENSITIZED PROCESSES in vivo: PROPOSED PHOTOTHERAPEUTIC APPLICATIONS * , 1990, Photochemistry and photobiology.

[23]  D. Doiron,et al.  Advances in laser skin surgery for vascular lesions. , 1985, Archives of otolaryngology.

[24]  J. Carruth,et al.  Photodynamic therapy in the treatment of malignant tumours of the skin and head and neck. , 1989, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[25]  D. Visscher,et al.  Photodynamic Therapy for Treatment of AIDS-Related Oral Kaposi's Sarcoma , 1990, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[26]  U. Nseyo,et al.  Photodynamic therapy for palliation of locally recurrent breast carcinoma. , 1987, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  R. Marchesini,et al.  Laser Phototherapy following HpD Administration in Superficial Neoplastic Lesions , 1984, Tumori.

[28]  Thomas S. Mang,et al.  THE THEORY OF PHOTODYNAMIC THERAPY DOSIMETRY: CONSEQUENCES OF PHOTO‐DESTRUCTION OF SENSITIZER , 1987 .

[29]  S. Waldow,et al.  Photodynamic therapy for treatment of malignant cutaneous lesions , 1987, Lasers in surgery and medicine.

[30]  L. Tomio,et al.  Photodynamic therapy: clinical experience at the Department of Radiotherapy at Padova General Hospital. , 1991, Journal of photochemistry and photobiology. B, Biology.