Kosmetische Medizin 4-2009: 168 – 174

Off-label photodynamic therapy

PIERGIACOMO CALZAVARA-PINTON1, MARIACHIARA ARISI1, BERNHARD ORTEL2

1 Department of Dermatology, University of Brescia, Piazzale Spedale Civile,
I-25123 Brescia, Italy
2 Section of Dermatology, University of Chicago Medical Center, 5841 South Maryland Avenue, MC-5067, Chicago, IL 60637,

KEY WORDS: Actinic keratoses,basal cell carcinoma, Bowen’s disease, photodynamic therapy, aminolevulinic acid (ALA)

SUMMARY:
Photodynamic therapy (PDT) has demonstrated high efficacy, minimal side effects, and improved cosmetic outcome for in the treatment of its EU-approved clinical indications, i.e. actinic keratoses, basal cell carcinoma, and Bowen’s disease. However, besides anti-tumoral activity, PDT has also demonstrated various anti-inflammatory and anti-infectious activities as well as those on the metabolism of connective tissue, keratinization of normal keratinocytes and maturation processes of sebaceous gland and hair follicle. These findings have expanded the spectrum of possible applications of PDT that now encompasses infectious (viral, bacterial, fungal, protozoal) disorders, epidermal and dermal inflammatory diseases, tumors of lymphocytes, adnexal diseases and premature skin aging due to sun exposure. However, the findings obtained so far must be considered in most cases only preliminary and more detailed studies are required to clarify the role of PDT beyond the treatment of non-melanoma skin cancer. In addition, possible advantages over standard treatments remain to be clarified.