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2 May 2008 Potential of systemic photosensitizers for PDT of skin malignancies
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Usually systemic photosensitizers (PS) require a long period of incubation (48-96h) after systemic admission. On the other hand clearing from healthy skin needs weeks or months. Severe side effects on skin are possible in case of uncontrolled light exposure. Topical PDT may solve this problem, but deep portions may not be sufficiently sensitized, resulting in a survival of some tumor cell population after PDT and recurrence. The same problem counts for actinic keratosis and Bowen's disease, but with even worse consequences as a resulting infiltrating growing squamous cell carcinoma (SCC) is likely to produce metastatic lesions. Light dosimetry is crucial also. Wavelenght, fluence and total energy may influence outcome of any PDT substantially. 17 patients with Bowen's disease or BCC where treated using a novel systemic PS (Fotolon®) and 665nm light from a diode laser. Follow up time ranges between 2.5 and 1 years after treatment. 2 patients received a second PDT, in 15 patients one treatment was efficient. We found a remissions in 1, local control in 2 and no evidence of disease in 14 patients. Significant fluorescence was noted in all lesions. With a light protection protocol for only 48 hours no severe side effects where seen. One patient developed mild redness of sunlight exposed skin sites 24h after being discharged from light protection protocol. In comparison with currently available topical PS Fotolon® offers some important advantages as secure photosenzitation of deep portions, single treatment, high selectivity combined with a high cure rate. In comparison with currently available systemic PS Fotolon® offers short incubation time, high selectivity and short time of elimination, while efficiency was comparable to HPD (hematoporphyrin-derivate) PDT combined with ALA-5 PDT and without need for additional local PS-application for PDD.
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Carsten M. Philipp, Ute Müller, Peter Urban, and H.-Peter Berlien "Potential of systemic photosensitizers for PDT of skin malignancies", Proc. SPIE 6991, Biophotonics: Photonic Solutions for Better Health Care, 699119 (2 May 2008);

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