Pseudoepitheliomatous hyperplasia treated by photodynamic therapy with variable irradiation dose and concentration of photosensitizer

Photomed Laser Surg. 2011 Feb;29(2):127-30. doi: 10.1089/pho.2009.2704. Epub 2010 Oct 22.

Abstract

Objective: The aim of this study was to test the effectiveness of photodynamic therapy (PDT) in treating pseudoepitheliomatous hyperplasia (PEH) after skin wounding.

Background data: PEH is a difficult-to-treat extreme-degree acanthosis characterized by proliferation of the epithelium. Topical PDT offers an effective and non-invasive treatment for intraepithelial neoplasia and inflammatory dermatosis. These disorders and PEH show the same histological features: epidermal hyperplasia. To our knowledge, there have been no clinical trials published about therapeutic responses of PDT for PEH.

Materials and methods: After application of 10-30% methyl aminolaevulinate (MAL) emulsion, each lesion was irradiated with 633-nm red light at a total dose of 113-339 J/cm(2). Therapeutic response was assessed by clinical examination at 3 months.

Results: Only 4 of 16 lesions clinically showed a minimal response. No response was observed in 12 of the 16 lesions, either with different cumulative doses or different concentrations of MAL.

Conclusion: PEH after skin wounding responds poorly to the topical MAL-PDT. Besides removal of underlying diseases, surgical excision is still the recommended first option.

MeSH terms

  • Adult
  • Aminolevulinic Acid / administration & dosage
  • Aminolevulinic Acid / analogs & derivatives*
  • Epidermis / pathology*
  • Female
  • Humans
  • Hyperplasia
  • Middle Aged
  • Photochemotherapy* / methods
  • Photosensitizing Agents / administration & dosage*
  • Skin Diseases / drug therapy*

Substances

  • Photosensitizing Agents
  • methyl 5-aminolevulinate
  • Aminolevulinic Acid