Dermatology 2013

Notes: Calzavara-Pinton, Pier Giacomo

Rossi, Maria Teresa

Aronson, Erica

Sala, Raffaella

eng

Clinical Trial

Multicenter Study

England

2012/09/06 06:00

Photochem Photobiol Sci. 2013 Jan;12(1):148-57. doi: 10.1039/c2pp25124h.

URL: http://www.ncbi.nlm.nih.gov/pubmed/22949035

Author Address: Department of Dermatology, University of Brescia, Brescia, Italy. fototerapia@spedalicivili.brescia.it

 

 

Reference Type:  Journal Article

Record Number: 4565Author: Calzavara-Pinton, P. G., Rossi, M. T., Sala, R. and Italian Group For Photodynamic, Therapy

Year: 2013

Title: A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications

Journal: Photochem Photobiol Sci

Volume: 12

Issue: 1

Pages: 158-65

Date: Jan

Short Title: A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications

Alternate Journal: Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology

ISSN: 1474-9092 (Electronic)

1474-905X (Linking)

DOI: 10.1039/c2pp25125f

Accession Number: 22949076

Keywords: Adolescent

Adult

Aged

Aged, 80 and over

Aminolevulinic Acid/*analogs & derivatives/therapeutic use

Female

Humans

Italy

Light

Male

Middle Aged

Photochemotherapy

Photosensitizing Agents/*therapeutic use

Retrospective Studies

Skin Diseases/*drug therapy

Treatment Outcome

Young Adult

Abstract: Photodynamic therapy (PDT) with methyl aminolevulinate (MAL) has been suggested as a useful treatment option in a number of skin tumors, other than approved indications, and infections. However, evidence is poor because it is mainly supported by isolated case reports or small case series, often with conflicting results. To assess the effectiveness, tolerability and safety of off-label MAL-PDT in daily clinical practice in 20 Italian hospitals, a retrospective observational study of medical records of patients treated for off-label oncologic and infectious skin conditions was carried out. In all patients standard treatment options had been either ineffective, unacceptably toxic, or medically contraindicated. Clinical data from 145 patients were analyzed. Actinic cheilitis showed a complete remission (CR) in 27 out of 43 treated patients and CR was maintained at follow-up. CR was registered in 3 of 8, 5 of 8 and 10 of 17 treated patients who were affected by extra-mammary Paget’s disease (EMPD), erythroplasia of Queyrat (QD), and invasive squamous cell carcinoma (SCC), respectively. Five out of 19 patients with cutaneous T cell lymphoma had a complete remission. Cutaneous B-cell lymphoma, malignant fibrous histiocytoma, mastocytosis and nevus sebaceous were not responsive. Warts were treated in 30 patients and 15 had a complete remission. However, periungueal and plantar lesions were much more responsive than flat and common lesions. Condylomata showed a CR in 2 out of 5 male patients but treatment was painful. Bowenoid papulosis showed only a partial improvement. Atypical mycobacteriosis and chronic cutaneous leishmaniasis were successfully treated. Submammary candidal intertrigo and interdigital intertrigo with Pseudomonas aeruginosa did not improve. Among off-label oncological uses of MAL-PDT, the therapy of actinic cheilitis was the most investigated and showed the best results. In addition, MAL-PDT was used successfully in the majority of patients with QD, EMPD and invasive SCC. Treatment of specific cutaneous infections was well tolerated and gave a good therapeutic result in a few patients, but it does not seem to give substantial advantages over conventional treatment options.

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