Photodynamic therapy in the dermatological field

Nakaseko Hirono, Matsumoto Yoshinari

doi:10.2530/jslsm.27.303

In photodynamic therapy (PDT), the combination of a tumor-localizing photosensitizer and visible light induces photochemical reactions in malignant tumors, selectively destroying tumor cells. In the dermatological field, this therapy has not been approved for health insurance. However, ALA-PDT, in which a porphyrin precursor, 5-aminolevulinic acid (ALA), is applied, is mainly performed, and is effective for actinic keratosis, Bowen's disease, and malignant superficial epithelial tumors of the skin, such as superficial basal cell carcinoma. Using an excimer dye laser with a wavelength of 630 nm, we performed ALA-PDT to treat actinic keratosis, Bowen,s disease, malignant superficial tumors of the skin including superficial basal cell carcinoma, lymphoma of the skin, extramammary Paget,s disease in which surgery was considered difficult, hyperplasia of the sebaceous gland, recalcitrant wart, acne vulgaris, and sarcoidosis. In particular, we obtained good treatment results in a large number of patients with actinic keratosis and Bowen's disease. Currently, the number of patients with malignant superficial tumors of the skin is increasing. ALA-PDT is a noninvasive procedure, and can be indicated for elderly patients, those with a poor general condition, and those refusing surgery. The necessity of PDT, which can be repeatedly performed without systemic side effects, and is cosmetically advantageous, will increase in the future. To allow the common use of PDT in the dermatological field, guidelines should be prepared.

Photodynamic therapy in the dermatological field

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