PDF Publication Title:
Text from PDF Page: 002
Biomedicines 2018, 6, 18 2 of 8 A major advantage of IPL-PDT as compared with conventional PDT is less time expenditure and less painful effects of heat delivery due to shorter intense exposure times [7]. IPL can also penetrate much deeper and trigger greater photodynamic reactions than other types of light sources. Although the use of IPL for ALA activation in the treatment of AK has been addressed in several studies, particularly as part of photorejuvenation process [8–12], there is a scarcity of literature describing the use of IPL for MAL activation in the treatment of AK, as well as sBCC and BD. MAL is reported to have increased lipophilicity and deeper skin penetration when compared with ALA. However, there is no statistically significant difference in efficacy between ALA and MAL in the treatment of AK [13]. We herein report our observational findings in a cohort of patients with a diagnosis of AK, sBCC, and BD treated with MAL-PDT using IPL as light source as well as we review published data on the use of IPL-PDT in NMSC. 2. Patients and Methods 2.1. Patients Twenty-five patients with AK, sBCC, and BD were enrolled. All of the patients were poor surgical candidates as their lesions were large, multiple, or in cosmetically sensitive areas. Diagnosis was established clinically and dermoscopically by two experienced dermatologists while biopsy specimens were taken in case of diagnostic doubt. Written informed consent regarding the potential benefits and risks of the procedure was obtained from each patient. Since MAL cream licence does not specify a particular light source for PDT, and these observations were carried out during our routine clinical practice, ethical approval was not sought. 2.2. Treatment Protocol Immediately prior to PDT, all of the hyperkeratotic lesions were treated with CO2 laser to increase cream and light penetration. MAL (Metvix®, Galderma Italia S.p.A, Agrate Brianza, Italy) was applied to lesion as a 1-mm thick layer, including 5 mm of the surrounding normal tissue, while in cases of multiple lesions it was applied to entire anatomic area. An occlusive nonabsorbent wrap and aluminium foil were placed over the MAL to increase penetration and eliminate light exposure, respectively. After an occlusion time of 3 h, MAL was removed. Before irradiation, the fluorescence of the lesion that was treated with MAL was detected by a Wood’s lamp photofluorescence. Subsequently, a thin layer of chilled gel was applied and irradiation was performed. All patients and investigators wore protective goggles during treatment. MAL was activated by an IPL device (Photosilk plus, DEKA M.E.L.A. S.r.l, Calenzano, Italy) set to the following parameters: cut-off wavelength, 550 nm; fluence, 18 J/cm2; triple pulse mode, 3.3, 3.9, and 4.6 ms in duration; interpulse delay, 100 ms with epidermal cooling already provided by the IPL handpiece. Patients with AK received three passages of irradiation in a single treatment session, while patients with sBCC and BD underwent four passages of irradiation in two treatment sessions at two-week interval. No analgesia or local anaesthesia was given. Post treatment care was limited to a topical antibacterial ointment and a sunscreen. Patients were strictly advised to avoid sunlight and to use sunscreen for the following 6 weeks. Clinical (both two-dimensional (2D) and three-dimensional (3D)) and dermoscopic images were captured in all of the cases before each treatment and six months following the last treatment. A special lens for dermoscopy (DermLite Foto; 3Gen LLC, San Juan Capistrano, CA, USA) connected to a digital camera (Canon PowerShot A360, Tokyo, Japan) was used for dermoscopic images, while a digital camera (Canon EOS 350D) and the 3D LifeViz® Micro system was used for two- and three-dimensional imaging of the lesions, respectively.PDF Image | Photodynamic Therapy Pulsed Light Treatment of Nonmelanoma
PDF Search Title:
Photodynamic Therapy Pulsed Light Treatment of NonmelanomaOriginal File Name Searched:
biomedicines-06-00018.pdfDIY PDF Search: Google It | Yahoo | Bing
Cruise Ship Reviews | Luxury Resort | Jet | Yacht | and Travel Tech More Info
Cruising Review Topics and Articles More Info
Software based on Filemaker for the travel industry More Info
The Burgenstock Resort: Reviews on CruisingReview website... More Info
Resort Reviews: World Class resorts... More Info
The Riffelalp Resort: Reviews on CruisingReview website... More Info
| CONTACT TEL: 608-238-6001 Email: greg@cruisingreview.com | RSS | AMP |