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Dermatology #Photodynamic Therapy

Photodynamic therapy is a therapeutic procedure which combines the application of a cream (a photosensitising agent) with the posterior exposition to light from a special lamp for a specific period of time for the treatment of various skin diseases.

 

Photodynamic therapy is a therapeutic procedure used in Medicine, principally in dermatology, for the treatment of various skin diseases, above all precancerous lesions (actinic keratosis), skin cancer (basal cell carcinoma and squamous cell carcinoma or squamocellular carcinoma in situ, Bowen’s disease), and it has also proved to be useful in some inflammatory diseases of the skin, as well as in photorejuvenation.

 
 

 
 

What is Actinic Keratosis?

Actinic Keratosis (AK) appears as a scaly or scabby eruption which shows up on the surface of the skin. The base may be clear or dark, the colouring may be burnt pink, red or a combination of these colours. This skin lesion generally develops slowly.

 

Actinic Keratosis usually appears on the face, the scalp, the back of the hands and arms etc., that is, on the areas of the body thqt are most exposed to sunlight. Hours of exposure to the sun accumulating over the years is the main cause of its development.

 
 

The importance of an early diagnosis

Actinic Keratosis may be the first step in the development of skin cancer. It is, therefore, a precursor to the cancer or a precancer, hence the importance of early diagnosis and treatment.

 

If they are treated early, almost all cases of actinic keratosis can be eliminated before they turn into skin cancer. But if they are not treated, it is estimated that approximately between 5 and 10% of these lesions may progress to the point of becoming a squamous cell carcinoma.

 
 

What is el Basal Cell Carcinoma?

Basal Cell Carcinoma (BCC) is the most frequent malign cutaneous tumour, it makes up more than 60% of skin cancers and it is more frequent in older patients.

 

Although it is a malign tumour, rarely does it reach the point of metastasis, but it can be destructive in localised areas, so early diagnosis is a fundamental element in its successful treatment.

 
 

Photodynamic Therapy

This method consists in applying on the area to be treated a specific cream (Methyl-aminolevulinate), which will be absorbed only by the cancerous cells. After a period of 2-3 hours, the dressings are taken off and the affected area is exposed to a lamp of red light. In this way, the generation of free radicals is stimulated only in the affected area, causing the destruction of the cancerous cells.

 

Its greatest advantages are its specificity, its selectivity (since it does not harm the healthy tissue), its safety and its scarce side effects.

 

Its application may also improve the results of other techniques such as surgery, since, when it is applied, it marks off the affected area better and thus facilitates the operation.

 

Also, it can be a guide as a method of detection of the lesions through fluorescence, determining the area of the lesion and what its extent may be.

 
 

What is the treatment like?

 

• On the day of the treatment, the scabs are removed from the lesion, the cream is applied and it is left covered for 2 to 3 hours. During this period, the patient may go home or to work. On his/her return, the cream is removed and the area which is to be treated is exposed to the light for about 10 minutes. In the case of carcinomas, two sessions of treatment are needed. In excepcional cases, additional sessions may be required.

 

• During the application of the light, the patient may feel an itching, burning sensation, heat or even pain, but these can be eased with the application of cold air in a spray or a local anaesthetic. After the treatment, he/she may continue to feel itching or burning for a day or two. Also, there may be some inflammation, scabbing and browned skin, which will improve over the following days.

 

• The wound should be kept covered for 24 hours, since during this period, the area is sensitive to light. The patient may shower quite normally, as long as he/she keeps the wound dry. In case of pain, he/she may take paracetamol or any other painkiller prescribed by the doctor. They should also follow the local care instructions indicated by the doctor.

 

• The scab will fall off around 7 to 10 days after the application of the light.

 

• The skin will be cured 2 to 3 weeks after the application. There may be some reddening and swelling.

 

• After 3 months, the skin is generally back to normal.

 

 
 

In the Dermatology Unit of HC Marbella, we have the latest technology for the treatment of these lesions, and we place a non-invasive technique such as Photodynamic Therapy at your disposition.

 

Sources: AEDV / Cancer. Gov /HC Marbella

 

 

July 24, 2019

 

 

 

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