Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.
TECe19-Dermatología Clínica y Traslacional, Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
Skin Res Technol. 2023 Dec;29(12):e13493. doi: 10.1111/srt.13493.
Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AKs), but there is little information on how PDT affects skin barrier function. The objectives of this study are: To compare skin barrier function between skin with AKs and healthy skin and to evaluate the impact of PDT on skin homeostasis in patients with AKs.
A prospective observational study was conducted in patients with AKs to evaluate epidermal barrier function and skin homeostasis before and 1 ek after receiving PDT.
A total of 21 subjects were included in the study, male/female ratio was 17:4, mean age was 75.86 years. The number of AKS observed before starting treatment was reduced with respect to those diagnosed 1 month after starting PDT (14.83 vs. 1.91, p < 0.0001). Application of PDT for treating AKs modifies epidermal barrier function. Immediately after the first session temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total antioxidant capacity (TAC) increased while pH decreased on lesional skin. After 1-month follow-up, the only remained change was the increased in SCH. Higher increases in temperature were observed when using occlusive PDT compared to mixed modality. 5-ALA and M-ALA seem to have a similar impact on skin barrier.
PDT can improve skin barrier function in patients with AKs. Skin homeostasis parameters can be used to assess efficacy and optimize dosing.
光动力疗法（PDT）是治疗光化性角化病（AK）的有效方法，但关于 PDT 如何影响皮肤屏障功能的信息较少。本研究的目的是：比较 AK 皮肤和健康皮肤的皮肤屏障功能，并评估 PDT 对 AK 患者皮肤内稳态的影响。
对 AK 患者进行前瞻性观察性研究，以评估接受 PDT 前后的表皮屏障功能和皮肤内稳态。
本研究共纳入 21 例患者，男/女比例为 17:4，平均年龄为 75.86 岁。与 PDT 开始后 1 个月诊断的 AK 数量相比，开始治疗前观察到的 AK 数量减少（14.83 例比 1.91 例，p<0.0001）。PDT 治疗 AK 会改变表皮屏障功能。第一次治疗后，皮损处皮肤温度、经皮水分丢失（TEWL）、角质层含水量（SCH）和总抗氧化能力（TAC）增加，而 pH 值降低。治疗 1 个月后，唯一的变化是 SCH 增加。与混合模式相比，使用封闭 PDT 时观察到更高的温度升高。5-ALA 和 M-ALA 似乎对皮肤屏障有相似的影响。
PDT 可改善 AK 患者的皮肤屏障功能。皮肤内稳态参数可用于评估疗效并优化剂量。
