ABSTRACT
Actinic keratoses (AKs) are one of the most common conditions that are treated by dermatologists and they have the potential to progress to squamous cell carcinoma if left untreated. Photodynamic therapy (PDT) has emerged as a novel and versatile method of treating those lesions. Topical preparations of aminolevulinic acid and methyl aminolevulinate are commercially available photosensitizers, and numerous light sources may be used for photoactivation. This article focuses on practical aspects of PDT in the treatment of AKs, outcomes of relevant clinical trials, and special applications of PDT in transplant recipients and other who are predisposed to AK formation. Step-by-step descriptions of PDT sessions are presented.
Subject(s)
Keratosis/drug therapy , Photochemotherapy , Ultraviolet Rays/adverse effects , Aminolevulinic Acid/analogs & derivatives , Aminolevulinic Acid/therapeutic use , Humans , Keratosis/etiology , Photosensitizing Agents/therapeutic useABSTRACT
BACKGROUND: Cutaneous squamous cell carcinoma (SCCA) is an important cause of death in patients with the severe form of recessive dystrophic epidermolysis bullosa (RDEB). These cancers often present with features that are different from those of actinically induced SCCA. OBJECTIVE: To emphasize the unusual features with which SCCA can present in RDEB and discuss early recognition of such cancers. METHODS: We present the case of a patient with RDEB who developed a cutaneous ulcer that appeared to be filled with heaped-up granulation tissue. Biopsy, however, showed moderately differentiated squamous cell carcinoma. RESULTS: The patient underwent wide surgical excision of the cancer, with split-thickness skin graft. She has remained disease-free three years later. CONCLUSION: In patients with RDEB, any ulcer that appears to be filled with heaped-up granulation tissue should be biopsied to rule out SCCA.
