Protection against photodynamic therapy (PDT)-induced photosensitivity by fabric materials.

"Special" highly protective fabrics are now available that offer broad-spectrum protection in preventing sunburn, and possibly other types of photodamage. It is important to know to what extent these fabrics are capable of protecting the wearer against skin cancer, photosensitivity disorders, and inadvertent phototoxic reactions from photodynamic therapy (PDT). We assess the ability of one such special (Solumbra) fabric and one "typical" summer fabric to provide protection against PDT phototoxicity produced in tape-stripped Sk-1 hairless mice by topical 5-aminolevulinic acid (ALA) and (primarily) visible light (360-800 nm). Since ALA-derived photosensitizers absorb most of the visible spectrum, results from these studies give a good indication of the photoprotective capability of these fabrics throughout this region. Mice were irradiated dorsally with a Kodak slide projector equipped with a 300 W tungsten-halogen lamp (I0 = 48.3 mW/cm2). After determining the minimal phototoxic dose (MPD) to be 1.40 +/- 0.4 J/cm2, we irradiated the tape-stripped ALA-sensitized mice through the stretched test fabrics with appropriate multiples of the MPD. The special fabric provided protection against 25-30 MPD visible light between 360-800 nm in 14/14 mice. The typical fabric failed to provide protection against 2.5 MPD of the same spectrum. No phototoxic or other adverse responses were seen with either the ALA or light control. In conclusion, the Solumbra fabric is much more protective against ALA photosensitization than the typical fabric. Both appear better at blocking UV than visible light.

Protection against UV photocarcinogenesis by fabric materials.

BACKGROUND: Clothing fabrics have long been considered effective protection against short-term and long-term sun damage. Recently, special "highly UV-protective" fabrics have been developed specifically for photosensitive patients. OBJECTIVE: To determine if one such fabric will protect hairless mice against (pre)malignant lesions under conditions that will produce skin cancers through a typical summer fabric of moderate sun protection factor (SPF). METHODS: After prior determination of minimal erythemal dose, four sets of 10 animals were divided into the following groups: (A) dark control (no irradiation); (B) positive control (no fabric); (C) "typical summer" fabric (SPF = 6.5 +/- 1.0); and (D) "special" fabric (SPF > 30 across a broad spectrum). Mice were irradiated on the dorsal surface 5 days per week, with biweekly incremental increases (roughly 20% of the starting dose), for 12 weeks. Group B started at 6.3 J/cm2, with biweekly increases of 1.45 J/cm2 (total dose, 596 J/cm2); groups After irradiation, mice were observed for clinical and histologic signs of pre(malignant lesions for an additional 12 weeks. RESULTS: At the end of the 12-week irradiation period, nine mice in group B and six mice in group C had actinic keratosis-like lesions, whereas one mouse in group B and two mice in group C had squamous cell carcinoma. By week 24, all mice in groups B and C had squamous cell carcinoma. Mice in groups A and D showed no discernable reaction at any time. Biopsy specimens confirmed the clinical results. CONCLUSION: Typical summer clothing fabrics may offer inadequate protection against skin cancer and pose high risk to chronically photosensitive patients. The use of appropriate sun protective apparel should offer effective protection to photosensitive patients against short-term and long-term photodamage.