Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Dermatolog Treat. 2010 Jul;21(4):245-51. doi: 10.3109/09546630903271548.
Psoriasis lesions accumulate protoporphyrin IX (PpIX) with a variable distribution within plaques due to variations in hyperkeratosis causing differences in penetration of cream or light.
To study the effects of different keratolytic pretreatments in PpIX-induced fluorescence diagnosis (FDAP) and during photodynamic therapy (PDT).
Two psoriasis plaques of 10 patients were treated with either topical retinoic acid or with a hydrocolloid dressing. The hydrocolloid dressing gave the best results. Subsequently, two different contralateral plaques of eight patients were pretreated with a hydrocolloid dressing or the standard pretreatment, salicylic acid in petrolatum, during the 6 weeks of PDT. Biopsies were investigated with respect to stratum corneum thickness, proliferation, differentiation and inflammation.
Irritation and point bleedings were noticed after retinoic acid. A hydrocolloid dressing induced the best clinical improvement. Therefore, it was used as alternative pretreatment for psoriasis prior to PDT. We observed significant clinical and immunohistochemical improvement of psoriasis in the salicylic acid as well as the hydrocolloid dressing pretreated plaques.
Salicylic acid in petrolatum and a hydrocolloid dressing prior to FDAP and PDT induce improvement of hyperkeratosis. Thus, a hydrocolloid dressing is a good alternative to the current keratolytic pretreatment regime.
由于角化过度的差异导致乳膏或光的渗透不同，银屑病斑块内的原卟啉 IX（PpIX）会以不同的分布方式积累。
研究不同的角质松解预处理对 PpIX 诱导荧光诊断（FDAP）和光动力疗法（PDT）的影响。
对 10 例患者的 2 个银屑病斑块分别用外用维甲酸或水胶体敷料进行治疗。水胶体敷料效果最好。随后，在 PDT 的 6 周内，对 8 例患者的 2 个不同的对侧斑块分别用水胶体敷料或标准预处理（凡士林中的水杨酸）进行预处理。对标本进行角质层厚度、增殖、分化和炎症的研究。
维甲酸治疗后出现刺激和点状出血。水胶体敷料引起的临床改善最佳。因此，它被用作 PDT 前银屑病的替代预处理。我们观察到在水杨酸和水胶体敷料预处理的斑块中，银屑病的临床和免疫组织化学均有显著改善。
在 FDAP 和 PDT 之前使用凡士林中的水杨酸和水胶体敷料可改善角化过度。因此，水胶体敷料是目前角质松解预处理方案的良好替代方法。
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