Department of Physics, Islamia College Peshawar, Khyber Pakhtunkhwa, Pakistan.
Services Hospital Lahore, Lahore, Pakistan.
Lasers Med Sci. 2024 Aug 29;39(1):226. doi: 10.1007/s10103-024-04174-0.
This systematic review evaluated the efficacy and safety of photodynamic therapy (PDT) in the management of cutaneous leishmaniasis (CL). The electronic search for identification of relevant studies, adhered to the PICOS (Population, Intervention, Comparator, Outcomes and Study type) framework, was conducted through PubMed, Google scholar, Dimensions, X-mol, and Semantic Scholar till December 2023. All types of studies reporting PDT in the management of CL with no language restriction were included. Methodological quality appraised of the selected studies was performed using Jadad index. Of the 317 identified studies, 21 reported PDT for the treatment of CL lesions, consisting of two randomized controlled trials (RCTs), four single-center open study, one case series and 14 case reports. Collectively, these studies presented a total of 304 patients with ages ranging from 1 to 82 years, undergoing varying number of PDT sessions (3-28) and follow-up durations spanning 4 weeks to 24 months. The CL lesions predominantly manifested on the exposed body areas, such as face, limbs, neck, ear and nose, and characterized with the use of clinical variables, such as plaques, papules, erythema and ulceration. PDT protocols differed in the photosensitizer type, incubation time, light source characteristics (e.g., wavelength, output power, and energy density), duration of light illumination, number of PDT sessions and their respective frequencies. Treatment response was assessed through the clinical presentation (i.e., at the baseline and after PDT completion) or by the absence of Leishmania parasites. Adverse effects comprised of pain, burning and tingling sensation experienced during PDT, followed by erythema, pigmentation changes and edema post-treatment. This systematic review revealed that PDT is an efficacious and safe modality for the treatment of CL, with mild and transient side effects.
这篇系统评价评估了光动力疗法（PDT）在治疗皮肤利什曼病（CL）中的疗效和安全性。通过 PubMed、Google Scholar、Dimensions、X-mol 和 Semantic Scholar 进行了电子搜索，以确定相关研究，搜索过程遵循 PICOS（人群、干预、对照、结局和研究类型）框架，截至 2023 年 12 月。所有类型的报告 PDT 治疗 CL 且无语言限制的研究均被纳入。使用 Jadad 指数对选定研究的方法学质量进行评估。在 317 项已确定的研究中，有 21 项研究报告了 PDT 治疗 CL 病变，包括两项随机对照试验（RCT）、四项单中心开放研究、一项病例系列研究和 14 项病例报告。这些研究总共报告了 304 名年龄在 1 至 82 岁之间的患者，他们接受了不同次数的 PDT 治疗（3-28 次），随访时间从 4 周到 24 个月不等。CL 病变主要发生在暴露的身体部位，如面部、四肢、颈部、耳朵和鼻子，其特征是使用临床变量，如斑块、丘疹、红斑和溃疡。PDT 方案在光敏剂类型、孵育时间、光源特性（如波长、输出功率和能量密度）、光照时间、PDT 治疗次数及其各自频率等方面存在差异。治疗反应通过临床表现（即在 PDT 完成前后）或通过不存在利什曼原虫寄生虫来评估。不良反应包括 PDT 期间经历的疼痛、烧灼感和刺痛感，以及治疗后出现的红斑、色素沉着改变和水肿。本系统评价表明，PDT 是治疗 CL 的一种有效且安全的方法，具有轻微且短暂的副作用。
