Bakirtzi Katerina, Papadimitriou Ilias, Vakirlis Efstratios, Lallas Aimilios, Sotiriou Eleni
First Department of Dermatology and Venereology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dermatol Pract Concept. 2023 Oct 1;13(4):e2023291. doi: 10.5826/dpc.1304a291.
Photodynamic therapy (PDT) with a photosensitizer is available for the treatment of multiple actinic keratoses (AKs) in a restricted skin area or, as it is established, for the field-cancerized skin.
Our review aims to present the up-to-date literature on skin field cancerization using PDT employing different topical photosensitizers, modified light delivery protocols and combination treatments to obtain excellent efficacy and safety in everyday clinical practice.
We sought PubMed, MEDLINE, Scopus, OVID, Embase, Science Direct, Cochrane Library, Research Gate and Google Scholar for [(aminolevulinic acid OR aminolevulinate) AND photodynamic therapy] with (field-directed OR field cancerization, (actinic keratosis), and (efficacy OR effectiveness OR pain OR tolerability) for studies published until February 2023.
Advantages of PDT compared to the other field treatments, including imiquimod, 5-fluorouracil, ingenol mebutate gel and diclofenac, reported better cosmetic outcomes and greater patient satisfaction. On the other hand, some drawbacks of field PDT include pain and treatment duration. Alternate illumination methods have also been investigated, including daylight as a light source. Pretreating the affected area may enhance photosensitizer absorption leading to better therapeutic results, while combinational treatments have also been tested. Patients prefer daylight PDT to traditional light sources since it is more well-tolerated and equally effective. Even as a preventive treatment, field PDT yields promising outcomes, especially for high-risk individuals, including organ transplant recipients.
This review provides a thorough display of the field of PDT on cancerized skin, which will facilitate physicians in applying PDT more efficiently and intuitively.
使用光敏剂的光动力疗法（PDT）可用于治疗局限皮肤区域内的多发性光化性角化病（AKs），或者如已证实的，用于皮肤场癌化的治疗。
我们的综述旨在呈现关于使用PDT进行皮肤场癌化治疗的最新文献，该治疗采用不同的局部光敏剂、改良的光传递方案以及联合治疗，以在日常临床实践中获得卓越的疗效和安全性。
我们在PubMed、MEDLINE、Scopus、OVID、Embase、Science Direct、Cochrane图书馆、Research Gate和谷歌学术上搜索了截至2023年2月发表的研究，搜索词为[(氨基酮戊酸或氨基酮戊酸盐) AND 光动力疗法] 以及 (场定向或场癌化、(光化性角化病)、以及 (疗效或有效性或疼痛或耐受性)。
与其他场治疗方法相比，包括咪喹莫特、5-氟尿嘧啶、鬼臼毒素酊凝胶和双氯芬酸，PDT的优势在于报告显示其具有更好的美容效果和更高的患者满意度。另一方面，场PDT的一些缺点包括疼痛和治疗持续时间。还研究了替代照明方法，包括使用日光作为光源。对受影响区域进行预处理可能会增强光敏剂的吸收，从而带来更好的治疗效果，同时也测试了联合治疗。患者更喜欢日光PDT而非传统光源，因为它的耐受性更好且效果相当。即使作为预防性治疗，场PDT也能产生有前景的结果，特别是对于高危个体，包括器官移植受者。
本综述全面展示了PDT在癌化皮肤领域的应用，这将有助于医生更高效、直观地应用PDT。
