Antonetti Paolo, Pellegrini Cristina, Caponio Chiara, Bruni Manfredo, Dragone Lorenzo, Mastrangelo Mirco, Esposito Maria, Fargnoli Maria Concetta
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
Dermatology Unit, Ospedale San Salvatore, 67100 L'Aquila, Italy.
Biomedicines. 2024 Apr 3;12(4):795. doi: 10.3390/biomedicines12040795.
Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3-5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.
鲍温病是皮肤鳞状细胞癌的原位形式；尽管其预后良好，但3%至5%的病变会进展为侵袭性皮肤鳞状细胞癌，免疫功能低下的患者风险更高。因此，治疗总是必要的，传统光动力疗法是一线选择。本综述的目的是概述光动力疗法治疗鲍温病的临床反应、复发率、安全性和美容效果，同时考虑在光敏剂、光源和联合治疗方面的不同方案。对于伤口愈合不良/延迟的部位、多发和/或大肿瘤以及手术困难或具有侵袭性的肿瘤，光动力疗法是一种有价值的选择。皮肤镜检查和反射式共聚焦显微镜检查可作为监测治疗反应的有价值工具。该治疗一般耐受性良好，副作用轻微，且美容效果良好/极佳。由于存在复发和进展为皮肤鳞状细胞癌的风险，光动力疗法后的定期随访至关重要。随着角质形成细胞肿瘤发病率的增加，光动力疗法的治疗空间将进一步扩大。
