Topical photodynamic therapy in the treatment of basal cell carcinoma in Singaporean Chinese patients.

Background: Topical photodynamic therapy has been used for the treatment of superfi cial and nodular basal cell carcinomas, with varying cure rates. Aims: This study aims to evaluate the effectiveness of topical photodynamic therapy in the treatment of superfi cial and nodular basal cell carcinomas in Asian patients treated at the National Skin Centre, Singapore. Materials and Methods: A retrospective analysis of Asian patients with histologically confi rmed basal cell carcinomas and treated with photodynamic therapy was performed. Results: Eight Chinese patients, with an equal gender distribution and mean age of 83.4 years were included. Five of eight basal cell carcinomas were superficial while the remaining three were nodular. The basal cell carcinomas were located in the head and neck in seven patients. The overall clearance rate at 3 months was 87.5% while the clearance rate for superfi cial and nodular basal cell carcinomas was 100% and 66.6% respectively at 3 months. At 12 months, the overall clearance rate was 85. 7%. Limitations: This is a retrospective analysis with small patient numbers. Conclusions: In this small series of eight Asian patients, topical photodynamic therapy has been shown to be effective and generally well-tolerated in the treatment of basal cell carcinomas, particularly of the superfi cial subtype. However, larger studies are needed to evaluate its overall efficacy in Asian patients.

Clinical characteristics of adult-onset actinic prurigo in Asians: A case series.

Background: Actinic prurigo (AP) is a chronic, pruritic skin condition caused by an abnormal reaction to sunlight. Aims: The aim of this study is to determine the clinical characteristics of AP in patients attending the National Skin Centre, Singapore, from 1st January 1999 to 30th June 2008. Methods: Cases of AP diagnosed from 1st January 1999 to 30th June 2008 were retrieved from the center’s electronic medical records and analyzed. Results: A total of 11 patients were diagnosed with AP. The mean age at diagnosis was 52 years. There were 9 (82%) Chinese and 2 (18%) Malay patients. Nine (82%) were male and 2 (18%) were female. The most commonly affected areas were the face, forearms, and hands (72%). Phototesting showed reduced minimal erythema dose (MED) to ultraviolet A (UVA) in 5 (46%) patients, both UVA and ultraviolet B (UVB) in 4 (36%) patients and UVB in 1 (9%) patient. Seven (64%) patients reported partial improvement after treatment with a combination of topical corticosteroids and sunscreens. Four (36%) patients received systemic therapy with partial response. Conclusion: Adult-onset AP is more common in the Asian population, with a male predominance. The face, forearms, and hands are the most commonly affected areas. The absence of mucosal involvement is also a distinguishing feature between the Asian and Caucasian population. Close to half of the patients have reduced MED to UVA on phototesting. The prognosis for AP is poor as it tends to run a chronic course with suboptimal response to treatment.