Zalewski Adam, Musiał Witold, Jankowska-Konsur Alina
Clinical Department of Oncodermatology, University Centre of General Dermatology and Oncodermatology, Wroclaw Medical University, Borowska 213, 50-556 Wrocław, Poland.
Department of Physical Chemistry and Biophysics, Wroclaw Medical University, Borowska 211A, 50-556 Wrocław, Poland.
J Clin Med. 2025 Apr 24;14(9):2956. doi: 10.3390/jcm14092956.
Primary cutaneous lymphomas (CLs) are a group of skin-limited lymphoproliferative disorders, including cutaneous T-cell (CTCLs) and B-cell lymphomas (CBCLs). Photodynamic therapy (PDT), a non-invasive, light-activated treatment, has gained attention as a skin-directed therapy for early-stage CLs due to its selectivity and favorable safety profile. This systematic review evaluates the current evidence on the clinical use of PDT in managing CLs. A systematic literature search was conducted in PubMed, Scopus, and Embase through 1 September 2024 following PRISMA guidelines. Search terms included "primary cutaneous skin lymphoma", "CTCL", "CBCL", "mycosis fungoides", "lymphomatoid papulosis", and "photodynamic therapy". After screening 1033 records, 30 studies were included. Data were extracted and categorized by lymphoma subtype and clinical outcomes. Of the included studies, 23 focused on mycosis fungoides (MF), 5 on lymphomatoid papulosis (LyP), and 2 on CBCL. PDT demonstrated notable clinical efficacy in early-stage and localized disease, particularly MF, using methyl aminolevulinate (MAL) or 5-aminolevulinic acid (5-ALA) as photosensitizers. Adjunctive techniques like microneedling and laser-assisted delivery improved treatment outcomes. PDT was generally well tolerated, with mild, transient side effects; rare complications such as localized neuropathy were reported. PDT is a promising, non-invasive treatment for early-stage CLs, especially MF and indolent CBCL variants. While current evidence supports its safety and effectiveness, further comparative and prospective studies are needed to refine protocols, evaluate long-term efficacy, and compare different photosensitizers.
原发性皮肤淋巴瘤（CLs）是一组局限于皮肤的淋巴增殖性疾病，包括皮肤T细胞淋巴瘤（CTCLs）和B细胞淋巴瘤（CBCLs）。光动力疗法（PDT）是一种非侵入性的光激活治疗方法，由于其选择性和良好的安全性，作为一种针对早期CLs的皮肤定向治疗方法受到了关注。本系统评价评估了PDT在治疗CLs方面临床应用的现有证据。按照PRISMA指南，于2024年9月1日前在PubMed、Scopus和Embase中进行了系统的文献检索。检索词包括“原发性皮肤淋巴瘤”、“CTCL”、“CBCL”、“蕈样肉芽肿”、“淋巴瘤样丘疹病”和“光动力疗法”。在筛选了1033条记录后，纳入了30项研究。数据按淋巴瘤亚型和临床结果进行提取和分类。在所纳入的研究中，23项聚焦于蕈样肉芽肿（MF），5项聚焦于淋巴瘤样丘疹病（LyP），2项聚焦于CBCL。使用甲基氨基乙酰丙酸（MAL）或5-氨基乙酰丙酸（5-ALA）作为光敏剂时，PDT在早期和局限性疾病，尤其是MF中显示出显著的临床疗效。微针和激光辅助给药等辅助技术改善了治疗效果。PDT总体耐受性良好，副作用轻微且短暂；报告了罕见的并发症，如局部神经病变。PDT是一种有前景的、非侵入性的早期CLs治疗方法，尤其是MF和惰性CBCL变体。虽然目前的证据支持其安全性和有效性，但需要进一步的比较研究和前瞻性研究来完善方案、评估长期疗效并比较不同的光敏剂。
