Liu Dihui, Zhao Shuang, Li Jinmao, Chen Mingliang, Wu Lisha
Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
Department of Dermatology, Guangzhou Integrated Traditional Chinese and Western Medicine Hospital, 87 Yingbin Avenue, Huadu District, Guangzhou, 510800, Guangdong, China.
Lasers Med Sci. 2021 Sep;36(7):1369-1377. doi: 10.1007/s10103-020-03233-6. Epub 2021 Jan 6.
Photodynamic therapy (PDT) is widely used in skin diseases; the response rate of PDT treatment varies widely. The limited penetration in the tissue of photosensitizers influenced the penetration depth of PDT, which obviously impacts the therapeutic effect. The studies have improved the efficacy of PDT through various pretreatment applications; especially, the physical pretreatment had achieved significant outcomes. We will review the physical pretreatment to optimize the efficacy of PDT in skin diseases by searching the literature on this topic. The types of physical pretreatment commonly used in the clinical practice are discussed: curettage, superficial shaving, laser, surgical resection, plum-blossom needles, and microneedles. Compared with PDT alone, the physical pretreatment before PDT application was generally improved the efficacy and reduced the recurrence, especially in actinic keratoses (AK), Bowen disease (BD), basal cell carcinoma (BCC), and viral warts. The application of the physical pretreatments before PDT may improve the efficacy of PDT in various skin diseases. However, each kind of physical pretreatment has the benefit and shortcoming, and the applicable situation is different.
光动力疗法（PDT）在皮肤病治疗中应用广泛；PDT治疗的有效率差异很大。光敏剂在组织中的穿透有限影响了PDT的穿透深度，这明显影响治疗效果。研究通过各种预处理应用提高了PDT的疗效；特别是物理预处理取得了显著成果。我们将通过检索关于该主题的文献来综述物理预处理，以优化PDT在皮肤病治疗中的疗效。讨论了临床实践中常用的物理预处理类型：刮除术、浅表剃除术、激光、手术切除、梅花针和微针。与单独使用PDT相比，在应用PDT之前进行物理预处理通常可提高疗效并降低复发率，尤其是在光化性角化病（AK）、鲍温病（BD）、基底细胞癌（BCC）和病毒疣方面。在PDT之前应用物理预处理可能会提高PDT在各种皮肤病中的疗效。然而，每种物理预处理都有其优点和缺点，适用情况也不同。
