Skin Department of Amaral Carvalho Hospital, Jahu, São Paulo, Brazil.
São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil.
Photodiagnosis Photodyn Ther. 2021 Mar;33:102154. doi: 10.1016/j.pdpdt.2020.102154. Epub 2021 Jan 7.
Photodynamic therapy (PDT) has been used worldwide as a non-surgical option for the treatment of basal cell carcinoma (BCC). PDT treatment for pigmented BCC is not frequently performed because of poorer results, which are explained by lower penetration of the light, possibly related to the melanin absorption in the visible range wavelengths. However, there is evidence for an increase in PDT cure rates with prior debulking of the lesion. In this study, we reported a complete clearance of 30 pigmented basal cell carcinomas in 2 patients. PDT was performed in a single visit protocol, which consists of two illumination sessions performed on the same day (125 mW/cm² of irradiance and 150 J/cm² of fluence). Imediately after the debulking of the BCC, a 20 % methyl aminolevulinate cream was applied and occluded for 3 h in the first session and 1.5 h in the second. After 30 days of the treatment, all regions were evaluated clinically and histologically, showing no residual BCC. Even with long-term follow-up (mean of 24 months), no recurrence was detected.. This PDT protocol achieved 100 % control for pigmented BCC. Therefore, it was demonstrated that PDT may be a successful treatment option for small and multiple pigmented BCC.
光动力疗法 (PDT) 已被全球广泛用作治疗基底细胞癌 (BCC) 的非手术选择。由于疗效较差，对色素性 BCC 的 PDT 治疗并不常见，其解释是光的穿透力较低，这可能与可见光范围内的黑色素吸收有关。然而，有证据表明，在对病变进行先期减瘤后，PDT 的治愈率会提高。在这项研究中，我们报告了 2 例患者的 30 例色素性基底细胞癌完全清除。PDT 是在单次就诊方案中进行的，该方案包括同一天进行的两次照射治疗（辐照度为 125 mW/cm²，剂量为 150 J/cm²）。在 BCC 减瘤后，立即应用 20%甲基氨基酮戊酸乳膏，第一次治疗时包封 3 小时，第二次治疗时包封 1.5 小时。治疗后 30 天，所有区域均进行临床和组织学评估，未发现残留的 BCC。即使进行长期随访（平均 24 个月），也未发现复发。这种 PDT 方案对色素性 BCC 的控制率达到 100%。因此，证明 PDT 可能是治疗小面积和多发性色素性 BCC 的一种成功治疗选择。
