1
|
SmartPDT®: Smartphone enabled real-time dosimetry via satellite observation for daylight photodynamic therapy. Photodiagnosis Photodyn Ther 2020; 31:101914. [PMID: 32645436 PMCID: PMC7336930 DOI: 10.1016/j.pdpdt.2020.101914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Actinic keratosis (AK) affects one quarter of over 60 year olds in Europe with the risk of transforming into invasive squamous cell carcinoma. Daylight photodynamic therapy (dPDT) is an effective and patient preferred treatment that uses sunlight to clear AK. Currently, there is no standardised method for measuring the light received during treatment. METHODS SmartPDT® is a smartphone-based application and web-portal, developed by siHealth Ltd, enabling remote delivery of dPDT. It uses satellite imagery and computational algorithms to provide real-time determination of exposure to PpIX-effective solar radiation ("light dose"). The application also provides forecast of expected radiant exposures for 24- and 48-hs prior to the treatment period. Validation of the real-time and forecasted radiant exposure algorithms was performed against direct ground-based measurement under all weather conditions in Chilton, UK. RESULTS Agreement between direct ground measurements and satellite-determined radiant exposure for 2-h treatment was excellent at -0.1 % ± 5.1 % (mean ± standard deviation). There was also excellent agreement between weather forecasted radiant exposure and ground measurement, 1.8 % ± 17.7 % at 24-hs and 1.6 % ± 25.2 % at 48-hs. Relative Root Mean Square of the Error (RMSEr) demonstrated that agreement improved as time to treatment reduced (RMSEr = 22.5 % (48 -hs), 11.2 % (24-hs), 5.2 % (real-time)). CONCLUSION Agreement between satellite-determined, weather-forecasted and ground-measured radiant exposure was better than any existing published literature for dPDT. The SmartPDT® application and web-portal has excellent potential to assist with remote delivery of dPDT, an important factor in reducing risk in an elderly patient population during the Covid-19 pandemic.
Collapse
|
2
|
O'Mahoney P, Khazova M, Eadie E, Ibbotson S. Measuring Daylight: A Review of Dosimetry in Daylight Photodynamic Therapy. Pharmaceuticals (Basel) 2019; 12:E143. [PMID: 31547141 PMCID: PMC6958468 DOI: 10.3390/ph12040143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/05/2019] [Accepted: 09/17/2019] [Indexed: 01/28/2023] Open
Abstract
Successful daylight photodynamic therapy (DPDT) relies on the interaction of light, photosensitisers and oxygen. Therefore, the 'dose' of light that a patient receives during treatment is a clinically relevant quantity, with a minimum dose for effective treatment recommended in the literature. However, there are many different light measurement methods used in the published literature, which may lead to confusion surrounding reliable and traceable dose measurement in DPDT, and what the most appropriate method of light measurement in DPDT might be. Furthermore, for the majority of practitioners who do not carry out any formal dosimetry and for the patients receiving DPDT, building confidence in the evidence supporting this important treatment option is of key importance. This review seeks to clarify the methodology of DPDT and discusses the literature relating to DPDT dosimetry.
Collapse
Affiliation(s)
- Paul O'Mahoney
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK.
| | | | - Ewan Eadie
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
| | - Sally Ibbotson
- Photobiology Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK.
- The Scottish Photodynamic Therapy Centre, Dundee DD1 9SY, UK.
- School of Medicine, University of Dundee, Dundee DD1 9SY, UK.
| |
Collapse
|
3
|
Use of 5-Aminolevulinic Acid and Daylight Photodynamic Therapy for the Treatment of Actinic Keratoses. Dermatol Surg 2019; 45:529-535. [DOI: 10.1097/dss.0000000000001771] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Sousa ACDS, Campos MAC, Baptista AM, Menezes NMBVN. Daylight photodynamic therapy in 25 patients with actinic keratosis and evaluation of efficacy by confocal microscopy. Photodiagnosis Photodyn Ther 2019; 25:414-416. [PMID: 30721758 DOI: 10.1016/j.pdpdt.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/18/2019] [Accepted: 02/01/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Daylight photodynamic therapy (PDT) has been reported as having similar efficacy to conventional photodynamic therapy in actinic keratosis treatment. METHODS 25 patients with actinic keratosis of the scalp and/or face were submitted to a daylight photodynamic therapy session. Adverse reactions were evaluated after one week and efficacy after 3 months. Confocal Microscopy was performed in 6 patients, before and one week after the treatment. Our aim was to compare our results with others studies and analyse the changes occurring in the epidermis and upper dermis with confocal microscopy. RESULTS 76% of the patients were male. The mean age was 74.2 years. In 51.7% of patients the treatment site was the scalp. Mean cure rate at 3 months was 74%. Aesthetic results were excellent in all patients and only one patient reported mild pain during the 2 h exposure. Confocal Microscopy showed a normalization of the honeycomb pattern in all of the patients. CONCLUSIONS This therapy has similar results to conventional photodynamic therapy and stands out for less discomfort, fewer adverse effects and better cost-effectiveness. Using confocal microscopy it's possible to in vivo demonstrate the efficacy of this method, with normalization of the honeycomb pattern in the epidermis following succcessful PDT.
Collapse
Affiliation(s)
- Ana Cristina da Silva Sousa
- Dermatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal.
| | - Manuel António Costa Campos
- Dermatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | - Armando Manuel Baptista
- Dermatology Department, Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal
| | | |
Collapse
|
5
|
Räsänen J, Neittaanmäki N, Ylitalo L, Hagman J, Rissanen P, Ylianttila L, Salmivuori M, Snellman E, Grönroos M. 5‐aminolaevulinic acid nanoemulsion is more effective than methyl‐5‐aminolaevulinate in daylight photodynamic therapy for actinic keratosis: a nonsponsored randomized double‐blind multicentre trial. Br J Dermatol 2019; 181:265-274. [DOI: 10.1111/bjd.17311] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 01/05/2023]
Affiliation(s)
- J.E. Räsänen
- Department of Dermatology Joint Authority for Päijät‐Häme Health and Wellbeing Lahti Finland
- Department of Dermatology Faculty of Medicine and Life Sciences Tampere University Hospital and University of Tampere Tampere Finland
| | - N. Neittaanmäki
- Departments of Pathology and Dermatology Institutes of Biomedicine and Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - L. Ylitalo
- Department of Dermatology Faculty of Medicine and Life Sciences Tampere University Hospital and University of Tampere Tampere Finland
| | - J. Hagman
- Department of Dermatology Vaasa Central Hospital Vaasa Finland
- Department of Dermatology Faculty of Medicine University of Turku Turku Finland
| | - P. Rissanen
- Faculty of Social Sciences (Health Sciences) University of Tampere Tampere Finland
| | - L. Ylianttila
- Radiation and Nuclear Safety Authority of Finland (STUK) Helsinki Finland
| | - M. Salmivuori
- Department of Dermatology Joint Authority for Päijät‐Häme Health and Wellbeing Lahti Finland
| | - E. Snellman
- Department of Dermatology Faculty of Medicine and Life Sciences Tampere University Hospital and University of Tampere Tampere Finland
| | - M. Grönroos
- Department of Dermatology Joint Authority for Päijät‐Häme Health and Wellbeing Lahti Finland
| |
Collapse
|
6
|
Szeimïes RM. Pain perception during photodynamic therapy: why is daylight PDT with methyl aminolevulinate almost pain-free? A review on the underlying mechanisms, clinical reflections and resulting opportunities. GIORN ITAL DERMAT V 2018; 153:793-799. [DOI: 10.23736/s0392-0488.18.06011-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
7
|
Abstract
Topical photodynamic therapy (PDT) using daylight is effective in the treatment of actinic keratoses (AKs), offering the potential for treatment of large fields such as full face and balding scalp, but with minimal therapy-associated pain. Comparison with conventional PDT indicates similar efficacy for thin and moderate-thickness AKs, but with significantly less discomfort/pain, driving a patient preference for daylight-mediated PDT (DL-PDT) compared with conventional PDT using high-intensity office/hospital-based light sources. Treatment protocol involves the application of a photosensitizing agent without occlusion and subsequent exposure to ambient daylight within 30 min, with patients exposed to daylight for 1.5-2.0 h. Pivotal randomized controlled trials in Europe and Australia have confirmed the efficacy of methyl aminolevulinic acid (MAL) DL-PDT in comparison with conventional MAL-PDT for mild and moderate-thickness lesions on the face and scalp. Initial clearance rates of 70-89% are reported. DL-PDT using a nanoemulsion aminolevulinic acid (ALA) has recently been shown to be at least as effective as MAL DL-PDT in treating mild and moderate-thickness AKs. DL-PDT may offer a better-tolerated method for treating patients with extensive AK disease. There is emerging literature on the potential for field PDT to reduce the number of new AKs developing, potentially preventing/slowing skin cancer development. Conventional PDT remains established as a therapy for Bowen's disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas (BCCs), and AKs. The evidence for the use of DL-PDT beyond AK is limited, although has been reported in actinic cheilitis, superficial BCC, and acne and cutaneous leishmaniasis. There is emerging interest in combination therapy for AK, using one or more field therapies such as DL-PDT as an option to complement with localized treatment for residual lesions. We review current recommendations and consider the appropriate place for DL-PDT in our treatment armamentarium.
Collapse
|
8
|
Manley M, Collins P, Gray L, O'Gorman S, McCavana J. Quantifying the radiant exposure and effective dose in patients treated for actinic keratoses with topical photodynamic therapy using daylight and LED white light. Phys Med Biol 2018; 63:035013. [PMID: 29192611 DOI: 10.1088/1361-6560/aa9ea7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Daylight photodynamic therapy (dl-PDT) is as effective as conventional PDT (c-PDT) for treating actinic keratoses but has the advantage of reducing patient discomfort significantly. Topical dl-PDT and white light-PDT (wl-PDT) differ from c-PDT by way of light sources and methodology. We measured the variables associated with light dose delivery to skin surface and influence of geometry using a radiometer, a spectral radiometer and an illuminance meter. The associated errors of the measurement methods were assessed. The spectral and spatial distribution of the radiant energy from the LED white light source was evaluated in order to define the maximum treatment area, setup and treatment protocol for wl-PDT. We compared the data with two red LED light sources we use for c-PDT. The calculated effective light dose is the product of the normalised absorption spectrum of the photosensitizer, protoporphyrin IX (PpIX), the irradiance spectrum and the treatment time. The effective light dose from daylight ranged from 3 ± 0.4 to 44 ± 6 J cm-2due to varying weather conditions. The effective light dose for wl-PDT was reproducible for treatments but it varied across the treatment area between 4 ± 0.1 J cm-2 at the edge and 9 ± 0.1 J cm-2 centrally. The effective light dose for the red waveband (615-645 nm) was 0.42 ± 0.05 J cm-2 on a clear day, 0.05 ± 0.01 J cm-2 on an overcast day and 0.9 ± 0.01 J cm-2 using the white light. This compares with 0.95 ± 0.01 and 0.84 ± 0.01 J cm-2 for c-PDT devices. Estimated errors associated with indirect determination of daylight effective light dose were very significant, particularly for effective light doses less than 5 J cm-2 (up to 83% for irradiance calculations). The primary source of error is in establishment of the relationship between irradiance or illuminance and effective dose. Use of the O'Mahoney model is recommended using a calibrated logging illuminance meter with the detector in the plane of the treatment area.
Collapse
Affiliation(s)
- M Manley
- Department of Medical Physics and Clinical Engineering, Saint Vincent's University Hospital, Dublin, Ireland. Author to whom any correspondence should be addressed
| | | | | | | | | |
Collapse
|
9
|
Galvão LEG, Gonçalves HDS, Botelho KP, Caldas JC. Daylight photodynamic therapy - Experience and safety in treatment of actinic keratoses of the face and scalp in low latitude and high brightness region. An Bras Dermatol 2017; 92:142-144. [PMID: 28225978 PMCID: PMC5312200 DOI: 10.1590/abd1806-4841.20175175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/02/2015] [Indexed: 11/22/2022] Open
Abstract
Daylight photodynamic therapy has been used in countries with high latitudes during the summer for actinic keratoses treatment with reports of similar efficacy to conventional photodynamic therapy. We evaluate its safety in 20 patients in the city of Fortaleza, a local with low latitude and high brightness. Sixteen patients did not report any discomfort due to the procedure. Daylight photodynamic therapy is an easy application method with great tolerability by the patient and has the possibility of being performed throughout the year in these regions. It can mean a promising tool in the control of skin cancer.
Collapse
Affiliation(s)
| | - Heitor de Sá Gonçalves
- Service of Dermatology of the Centro de Dermatologia Dona Libânia - Fortaleza (CE), Brazil
| | | | - Juliana Chagas Caldas
- Service of Dermatology of the Centro de Dermatologia Dona Libânia - Fortaleza (CE), Brazil
| |
Collapse
|
10
|
Wen X, Li Y, Hamblin MR. Photodynamic therapy in dermatology beyond non-melanoma cancer: An update. Photodiagnosis Photodyn Ther 2017. [PMID: 28647616 DOI: 10.1016/j.pdpdt.2017.06.010] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Photodynamic therapy (PDT) employs a photosensitizer (PS) and visible light in the presence of oxygen, leading to production of cytotoxic reactive oxygen species, which can damage the cellular organelles and cause cell death. In dermatology, PDT has usually taken the form of topical application of a precursor in the heme biosynthesis pathway, called 5-aminolevulinic acid (or its methyl ester), so that an active PS, protoporphyrin IX accumulates in the skin. As PDT enhances dermal remodeling and resolves chronic inflamation, it has been used to treat cutaneous disorders include actinic keratoses, acne, viral warts, skin rejuvenation, psoriasis, localized scleroderma, some non-melanoma skin cancers and port-wine stains. Efforts are still needed to mitigate the side effects (principally pain) and improve the overall procedure.
Collapse
Affiliation(s)
- Xiang Wen
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, Sichuan,610041,China; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA
| | - Yong Li
- Department of Dermatology, West China Hospital of Sichuan University, Chengdu, Sichuan,610041,China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA 02115, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA 02139, USA.
| |
Collapse
|
11
|
Switching From Conventional Photodynamic Therapy to Daylight Photodynamic Therapy For Actinic Keratoses: Systematic Review and Meta-analysis. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
12
|
Tomás-Velázquez A, Redondo P. Switching From Conventional Photodynamic Therapy to Daylight Photodynamic Therapy For Actinic Keratoses: Systematic Review and Meta-analysis. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:282-292. [PMID: 28063524 DOI: 10.1016/j.ad.2016.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/02/2016] [Accepted: 09/17/2016] [Indexed: 01/08/2023] Open
Abstract
Actinic keratosis is a precursor lesion to the most common nonmelanoma skin cancer. Conventional photodynamic therapy (PDT) has been shown to be effective, but the procedure is time-consuming, can be very painful, and requires infrastructure. These shortcomings led to the emergence of daylight PDT. To obtain a global estimate of efficacy, we undertook a systematic literature review and performed a meta-analysis of the available evidence on the efficacy and safety of daylight PDT as compared to conventional PDT in the treatment of actinic keratosis and/or field cancerization. The conclusion is that the difference in efficacy is clinically negligible (global estimate of the mean response rate difference, -3.69%; 95% CI, -6.54% to -0.84%). The adverse effects of daylight PDT are mild and localized (79% of patients report no discomfort), and patients report less pain (P<.001). Daylight PDT gives good to excellent cosmetic results in more than 90% of patients, and patient satisfaction is greater (P<.001).
Collapse
Affiliation(s)
- A Tomás-Velázquez
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España.
| | - P Redondo
- Departamento de Dermatología, Clínica Universidad de Navarra, Pamplona, España
| |
Collapse
|
13
|
Ibbotson S, Stones R, Bowling J, Campbell S, Kownacki S, Sivaramakrishnan M, Valentine R, Morton CA. A consensus on the use of daylight photodynamic therapy in the UK. J DERMATOL TREAT 2016; 28:360-367. [PMID: 27788605 DOI: 10.1080/09546634.2016.1240863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Sally Ibbotson
- Photobiology Unit, Department of Dermatology, Ninewells Hospital & Medical School, Dundee, UK
| | - Robin Stones
- Department of Dermatology, East Cheshire NHS Trust, Macclesfield, UK
| | - Jonathan Bowling
- Private Dermatology Practice, London, UK
- Private Dermatology Practise, Oxford, UK
| | - Sandra Campbell
- Dermatology Department, The Royal Cornwall Hospital, Truro, UK
| | | | - Muthu Sivaramakrishnan
- Photobiology Unit, Department of Dermatology, Ninewells Hospital & Medical School, Dundee, UK
| | | | | |
Collapse
|
14
|
Cantisani C, Paolino G, Pellacani G, Didona D, Scarno M, Faina V, Gobello T, Calvieri S. MAL Daylight Photodynamic Therapy for Actinic Keratosis: Clinical and Imaging Evaluation by 3D Camera. Int J Mol Sci 2016; 17:ijms17071108. [PMID: 27409613 PMCID: PMC4964483 DOI: 10.3390/ijms17071108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/13/2016] [Accepted: 06/30/2016] [Indexed: 11/16/2022] Open
Abstract
Non-melanoma skin cancer is the most common skin cancer with an incidence that varies widely worldwide. Among them, actinic keratosis (AK), considered by some authors as in situ squamous cell carcinoma (SCC), are the most common and reflect an abnormal multistep skin cell development due to the chronic ultraviolet (UV) light exposure. No ideal treatment exists, but the potential risk of their development in a more invasive form requires prompt treatment. As patients usually present with multiple AK on fields of actinic damage, there is a need for effective, safe, simple and short treatments which allow the treatment of large areas. To achieve this, daylight photodynamic therapy (DL-PDT) is an innovative treatment for multiple mild actinic keratosis, well tolerated by patients. Patients allocated to the PDT unit, affected by multiple mild-moderate and severe actinic keratosis on sun-exposed areas treated with DL-PDT, were clinically evaluated at baseline and every three months with an Antera 3D, Miravex(©) camera. Clinical and 3D images were performed at each clinical check almost every three months. In this retrospective study, 331 patients (56.7% male, 43.3% female) were treated with DL-PDT. We observed a full clearance in more than two-thirds of patients with one or two treatments. Different responses depend on the number of lesions and on their severity; for patients with 1-3 lesions and with grade I or II AK, a full clearance was reached in 85% of cases with a maximum of two treatments. DL-PDT in general improved skin tone and erased sun damage. Evaluating each Antera 3D images, hemoglobin concentration and pigmentation, a skin color and tone improvement in 310 patients was observed. DL-PDT appears as a promising, effective, simple, tolerable and practical treatment for actinic damage associated with AK, and even treatment of large areas can be with little or no pain. The 3D imaging allowed for quantifying in real time the aesthetic benefits of DL-PDT's increasing compliance.
Collapse
Affiliation(s)
- Carmen Cantisani
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Giovanni Paolino
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena 41121, Italy.
| | - Dario Didona
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Marco Scarno
- Interuniversity Consortium for Supercomputing (CINECA), Rome 00185, Italy.
| | - Valentina Faina
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Tommaso Gobello
- Istituto Dermopatico dell'Immacolata (IDI) Hospital, Rome 00195, Italy.
| | - Stefano Calvieri
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| |
Collapse
|
15
|
Grinblat B, Galimberti G, Pantoja G, Sanclemente G, Lopez M, Alcala D, Torezan L, Kerob D, Pascual T, Chouela E. Feasibility of daylight‐mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study. Int J Dermatol 2016; 55:e488-93. [DOI: 10.1111/ijd.13256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 11/17/2015] [Indexed: 01/05/2023]
Affiliation(s)
- Beni Grinblat
- Department of Dermatology Hospital das Clínicas University of São Paulo São Paulo SP Brazil
| | - Gaston Galimberti
- Department of Dermatology School of Medicine Hospital Italiano Buenos Aires Argentina
| | | | - Gloria Sanclemente
- Group of Investigative Dermatology (GRID) School of Medicine University of Antioquia Medellín Colombia
| | - Miguel Lopez
- Cirugía Dermatológica y Oncología Cutánea Department Hospital Militar Dr Carlos Arvelo Central University of Venezuela Caracas Venezuela
| | - Daniel Alcala
- Centro Dermatológico Dr Ladislao de la Pascua Mexico City Mexico
| | - Luís Torezan
- Department of Dermatology Hospital das Clínicas University of São Paulo São Paulo SP Brazil
| | | | | | - Edgardo Chouela
- Centro de Investigaciones Dermatologicas Hospital General de Agudos “Dr Cosme Argerich” Buenos Aires Argentina
| |
Collapse
|
16
|
Sanclemente G, Mancilla G, Hernandez G. A double-blind randomized controlled trial to assess the efficacy of daylight photodynamic therapy with methyl-aminolevulinate vs. Placebo and daylight in patients with facial photodamage. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2015.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
17
|
|
18
|
Grinblat B, Galimberti G, Chouela E, Sanclemente G, Lopez M, Alcala D, Torezan L, Pantoja G. Daylight‐mediated photodynamic therapy for actinic damage in Latin America: consensus recommendations. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2015; 32:81-7. [DOI: 10.1111/phpp.12221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Beni Grinblat
- Department of Dermatology Hospital das Clinicas University of Sao Paulo Sao Paulo Brazil
| | - Gaston Galimberti
- Department of Dermatology School of Medicine Hospital Italiano Buenos Aires Argentina
| | - Edgardo Chouela
- Centro de Investigaciones Dermatológicas Buenos Aires Argentina
| | - Gloria Sanclemente
- Group of Investigative Dermatology (GRID) School of Medicine University of Antioquia Medellín Colombia
| | - Miguel Lopez
- Cirugía Dermatológica y Oncología Cutánea Department Hospital Militar “Dr. Carlos Arvelo” Caracas Venezuela
| | - Daniel Alcala
- Centro Dermatológico Dr. Ladislao de la Pascua Ciudad de México Mexico
| | - Luís Torezan
- Department of Dermatology Hospital das Clinicas University of Sao Paulo Sao Paulo Brazil
| | | |
Collapse
|
19
|
Sanclemente G, Mancilla GA, Hernandez G. A double-blind randomized controlled trial to assess the efficacy of daylight photodynamic therapy with methyl-aminolevulinate vs. Placebo and daylight in patients with facial photodamage. ACTAS DERMO-SIFILIOGRAFICAS 2015; 107:224-34. [PMID: 26643786 DOI: 10.1016/j.ad.2015.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/02/2015] [Accepted: 10/12/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Daylight PDT (dPDT) is easy to use and does not require light equipment. Such therapy has been exhaustively proved to be successful in the treatment of actinic keratosis, but its use in skin photodamage remains unclear. OBJECTIVE To evaluate dPDT's efficacy in skin facial photodamage. PATIENTS AND METHODS This was a parallel-group double-blind, randomized placebo-controlled trial. Sixty participants with symmetric facial photodamage were allocated to topical methyl aminolevulinate (MAL) and daylight vs. matching placebo and daylight. Primary outcome was global photodamage improvement/failure 1 month after the third session. Secondary outcomes included: pain evaluation; specific photodamage severity scores; sun irradiance quantification and Skindex-29 scores. Adverse events were also investigated. RESULTS Primary analysis included all randomized patients. All patients sun-exposed for 120min in 3 sessions. The risk of failure was lower in the MAL-dPDT group than in the placebo plus daylight group (RR: 0.18; 95% CI: 0.08-0.41). Mean solar irradiance (W/m(2)) during the first, second and third sessions was 480.82, 430.07 and 435.84, respectively. Items 5 and 14 of Skindex-29 in the MAL-dPDT group showed statistical significant differences. Two patients in the MAL-dPDT group had serious and non-serious events not directly related to the product. CONCLUSION dPDT with MAL was un-painful, effective and safe for the treatment of facial photodamage. Herpes simplex prophylaxis should be considered before sessions.
Collapse
Affiliation(s)
- G Sanclemente
- IPS Universitaria, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación Dermatológica (GRID), Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - G A Mancilla
- Grupo de Investigación Dermatológica (GRID), Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - G Hernandez
- Grupo de Investigación Dermatológica (GRID), Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
20
|
Salas-García T, López-Gómez A, Dorado-Fernández M, Ruiz-Martínez J. Daylight Photodynamic Therapy. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
21
|
Gilaberte Y, Aguilar M, Almagro M, Correia O, Guillén C, Harto A, Pérez-García B, Pérez-Pérez L, Redondo P, Sánchez-Carpintero I, Serra-Guillén C, Valladares L. Spanish-Portuguese Consensus Statement on the Use of Daylight Photodynamic Therapy With Methyl Aminolevulinate in the Treatment of Actinic Keratosis. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
22
|
Salas-García T, López-Gómez A, Dorado-Fernández M, Ruiz-Martínez J. Daylight photodynamic therapy. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:672-3. [PMID: 26138286 DOI: 10.1016/j.ad.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 05/03/2015] [Accepted: 05/05/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- T Salas-García
- Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, España.
| | - A López-Gómez
- Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, España
| | - M Dorado-Fernández
- Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, España
| | - J Ruiz-Martínez
- Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, España
| |
Collapse
|
23
|
Gilaberte Y, Aguilar M, Almagro M, Correia O, Guillén C, Harto A, Pérez-García B, Pérez-Pérez L, Redondo P, Sánchez-Carpintero I, Serra-Guillén C, Valladares LM. Spanish-Portuguese consensus statement on use of daylight-mediated photodynamic therapy with methyl aminolevulinate in the treatment of actinic keratosis. ACTAS DERMO-SIFILIOGRAFICAS 2015; 106:623-31. [PMID: 26115793 DOI: 10.1016/j.ad.2015.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 05/28/2015] [Accepted: 06/01/2015] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Daylight-mediated photodynamic therapy (PDT) is a new type of PDT that is as effective as conventional PDT in grade 1 and 2 actinic keratosis but with fewer adverse effects, resulting in greater efficiency. The climatic conditions in the Iberian Peninsula require an appropriately adapted consensus protocol. OBJECTIVE We describe a protocol for the treatment of grade 1 and 2 actinic keratosis with daylight-mediated PDT and methyl aminolevulinate (MAL) adapted to the epidemiological and clinical characteristics of Spanish and Portuguese patients and the climatic conditions of both countries. METHODS Twelve dermatologists from different parts of Spain and Portugal with experience in the treatment of actinic keratosis with PDT convened to draft a consensus statement for daylight-mediated PDT with MAL in these countries. Based on a literature review and their own clinical experience, the group developed a recommended protocol. RESULTS According to the recommendations adopted, patients with multiple grade 1 and 2 lesions, particularly those at risk of developing cancer, are candidates for this type of therapy. Daylight-mediated PDT can be administered throughout the year, although it is not indicated at temperatures below 10°C or at excessively high temperatures. Likewise, therapy should not be administered when it is raining, snowing, or foggy. The procedure is simple, requiring application of a sunscreen with a protection factor of at least 30 based exclusively on organic filters, appropriate preparation of the lesions, application of MAL without occlusion, and activation in daylight for 2hours. CONCLUSION This consensus statement represents a practical and detailed guideline to achieve maximum effectiveness of daylight-mediated PDT with MAL in Spain and Portugal with minimal adverse effects.
Collapse
Affiliation(s)
- Y Gilaberte
- Unidad de Dermatología, Hospital San Jorge, Huesca, España.
| | - M Aguilar
- Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - M Almagro
- Servicio de Dermatología, Complejo Hospitalario Universitario, La Coruña, España
| | - O Correia
- Centro de Dermatología Epidermis, Instituto CUF, Oporto y Facultad de Medicina, Universidad de Oporto, Oporto, Portugal
| | - C Guillén
- Servicio de Dermatología, Instituto Valencia de Oncología, Valencia, España
| | - A Harto
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - B Pérez-García
- Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España
| | - L Pérez-Pérez
- Servicio de Dermatología, Estructura Organizativa de Gestión Integrada (EOXI) de Vigo, Clínica Pérez & Gavín dermatólogos, Vigo, España
| | - P Redondo
- Servicio de Dermatología, Clínica Universitaria de Navarra, Pamplona, España
| | | | - C Serra-Guillén
- Servicio de Dermatología, Instituto Valencia de Oncología, Valencia, España
| | - L M Valladares
- Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España
| |
Collapse
|
24
|
Morton C, Wulf H, Szeimies R, Gilaberte Y, Basset-Seguin N, Sotiriou E, Piaserico S, Hunger R, Baharlou S, Sidoroff A, Braathen LR. Practical approach to the use of daylight photodynamic therapy with topical methyl aminolevulinate for actinic keratosis: a European consensus. J Eur Acad Dermatol Venereol 2015; 29:1718-23. [DOI: 10.1111/jdv.12974] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 12/19/2014] [Indexed: 01/05/2023]
Affiliation(s)
- C.A. Morton
- Department of Dermatology; Stirling Community Hospital; Stirling UK
| | - H.C. Wulf
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - R.M. Szeimies
- Department of Dermatology and Allergology; Klinikum Vest GmbH Academic Teaching Hospital; Recklinghausen Germany
| | - Y. Gilaberte
- Department of Dermatology; Hospital San Jorge; Huesca Spain
| | | | - E. Sotiriou
- First Dermatology Department; Aristotle University; Thessaloniki Greece
| | - S. Piaserico
- Unit of Dermatology; Department of Medicine; University of Padova; Padova Italy
| | - R.E. Hunger
- Department of Dermatology; Inselspital; University of Bern; Bern Switzerland
| | - S. Baharlou
- Department of Dermatology; Vrije Universiteit Brussel (VUB); Universitair Ziekenhuis UZ Brussel; Brussels Belgium
| | - A. Sidoroff
- Department of Dermatology and Venereology; Medical University, Innsbruck; Innsbruck Austria
| | - L. R. Braathen
- Dermatology; Bern Im Holenacker 16 CH-3063 Ittigen Switzerland
| |
Collapse
|
25
|
Wulf HC. Increasing the acceptability of photodynamic therapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2014; 31:3-4. [DOI: 10.1111/phpp.12142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Hans Christian Wulf
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| |
Collapse
|