Department of Dermatology, Stirling Community Hospital, Stirling, UK.
Department of Dermatology and Allergology, Klinikum Vest GmbH Academic Teaching Hospital, Recklinghausen, Germany.
Eur J Dermatol. 2023 Oct 1;33(5):467-473. doi: 10.1684/ejd.2023.4562.
This article reviews the 2022 European Society for Photodynamic Therapy (Euro-PDT) Annual Congress. PDT has been investigated for the treatment of a broad number of oncologic, infectious and inflammatory indications. New studies confirm the potential for wider use of topical PDT for acne and photoaging, as well as several uncommon conditions including tinea capitis, Mycobacterium marinum, cutaneous alternariosis, resistant acral warts, eyelid Bowen's disease, mycosis fungoides, pseudolymphoma, and graft-versus-host disease. Hidradenitis suppurativa patients may also benefit from intra-lesional PDT. Several methods of delivering PDT have been validated, including conventional, daylight and artificial daylight PDT. Light-emitting fabrics have emerged as an innovative solution to the delivery of uniform light over the scalp as well as anatomically-challenging sites, with opportunities now to control and monitor these devices via mobile phone applications. Pre-treatment of patients with thicker, more difficult-to-treat actinic keratoses (AK) with calcitriol appears to be a practical approach to increasing efficacy, although this is associated with increased local skin reactions. Sequential treatment of AK and photoaging with daylight-PDT and injectable NASHA gel indicates that these two therapeutic approaches offer complementary effects. Potential biomarkers may help predict responsiveness of patients with field cancerization and AK receiving daylight PDT. Over-expression of the proto-oncogene, Myc, has been observed in poor responders, whilst the tumour suppressor gene, PTEN, showed under-expression. The potential for use and methods of delivery of topical PDT for dermatological indications continue to expand the enhanced choice of treatment offered to patients.
本文回顾了 2022 年欧洲光动力疗法学会(Euro-PDT)年会。光动力疗法已被广泛研究用于治疗多种肿瘤、感染和炎症性疾病。新的研究证实,局部光动力疗法在治疗痤疮和光老化方面具有更广泛的应用潜力,同时也可用于一些罕见疾病,如头癣、海分枝杆菌感染、皮肤交链孢霉病、耐药性跖疣、眼睑 Bowen 病、蕈样肉芽肿、假性淋巴瘤和移植物抗宿主病。化脓性汗腺炎患者也可能受益于 PDT 局部治疗。已经验证了多种光动力疗法的递送方法,包括常规、日光和人工日光 PDT。发光织物已成为头皮和解剖学上具有挑战性部位均匀光递送的创新解决方案,现在有机会通过手机应用程序来控制和监测这些设备。在治疗更厚、更难治疗的光化性角化病(AK)患者时,预先使用骨化三醇似乎是提高疗效的一种实用方法,尽管这会增加局部皮肤反应。日光 PDT 与注射型 NASHA 凝胶序贯治疗 AK 和光老化表明,这两种治疗方法具有互补作用。潜在的生物标志物可能有助于预测接受日光 PDT 的区域性癌变和 AK 患者的反应性。在反应不佳的患者中观察到原癌基因 Myc 的过度表达,而肿瘤抑制基因 PTEN 则表现出低表达。局部光动力疗法用于皮肤科适应证的应用潜力和递送方法继续扩大了为患者提供的治疗选择。