University Hospital Ramón, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2012 Jul;26(7):868-74. doi: 10.1111/j.1468-3083.2011.04175.x. Epub 2011 Jul 9.
Bowen disease (BD) or squamous cell carcinoma (SCC) in situ affects both skin and mucous membranes and has the potential to progress to invasive SCC. Photodynamic therapy (PDT) has been approved recently for the treatment of BD. Some studies have demonstrated its efficacy and good cosmetic outcome.
To assess the efficacy of PDT in the treatment of BD.
We carried out an observational, retrospective and descriptive study. A total of 47 patients with 51 lesions of BD were included. All the lesions were confirmed with previous cutaneous biopsy. All patients were treated with the standard protocol. Topical methyl-aminolaevulinic acid was occluded during 3 h and followed by illumination with red-light (630 nm, 38 J/cm2, 7.5 min). Clinical and fluorescence photographs images were taken before each session. All patients received two sessions one week apart. Clinical response was classified in partial or complete response. Fluorescence response was classified in negative, intermediate or intense. The follow-up period and the adverse events observed including pain were also collected.
A total of 20 men and 27 women with a mean age of 75.57 years old were treated with PDT. Lesions were most frequently located in the lower limbs. Globally, 76.09% of the lesions achieved complete response after 2 sessions with a medium follow-up of 16.61 months. Fluorescence of the lesions disappeared when clinical response was achieved, but not always. The most common adverse effect was an immediate burning sensation. All lesions showed an excellent cosmetic result.
Photodynamic therapy is an effective treatment for BD in terms of both clinical remission and cosmetic results, with good tolerance and minimal adverse effects.
Bowen 病（BD）或鳞状细胞癌（SCC）原位影响皮肤和粘膜，并有可能进展为侵袭性 SCC。光动力疗法（PDT）最近已被批准用于治疗 BD。一些研究已经证明了它的疗效和良好的美容效果。
评估 PDT 治疗 BD 的疗效。
我们进行了一项观察性、回顾性和描述性研究。共纳入 47 例 51 处 BD 病变患者。所有病变均经先前的皮肤活检证实。所有患者均采用标准方案治疗。局部应用甲氨基酮戊酸，避光 3 小时，然后用红光（630nm，38J/cm2，7.5 分钟）照射。每次治疗前均拍摄临床和荧光照片。所有患者均间隔一周接受两次治疗。临床反应分为部分或完全反应。荧光反应分为阴性、中等或强烈。还收集了随访时间和观察到的不良反应（包括疼痛）。
共治疗 20 例男性和 27 例女性患者，平均年龄为 75.57 岁。病变最常位于下肢。2 次治疗后，76.09%的病变获得完全缓解，平均随访时间为 16.61 个月。当临床反应达到时，病变的荧光消失，但并非总是如此。最常见的不良反应是立即出现烧灼感。所有病变均获得极佳的美容效果。
光动力疗法在临床缓解和美容效果方面都是治疗 BD 的有效方法，具有良好的耐受性和最小的不良反应。
