PDT and Actinic Cheilitis

The Efficacy of Photodynamic Therapy in Actinic Cheilitis of the Lower Lip: A Prospective Study of 15 Patients
Authors: BERKING, CAROLA1; HERZINGER, THOMAS1; FLAIG, MICHAEL J.1; BRENNER, MICHAELA1; BORELLI, CLAUDIA1; DEGITZ, KLAUS1

Source: Dermatologic Surgery, Volume 33, Number 7, July 2007 , pp. 825-830(6)

Abstract:

BACKGROUND

Photodynamic therapy (PDT) has been developed into a widely used method to treat actinic keratoses and basal cell carcinoma. OBJECTIVE

The objective was to assess the efficacy of PDT in the treatment of actinic cheilitis of the lower lip. METHODS

In this prospective, uncontrolled study at a university dermatology department, 15 patients with actinic cheilitis received two sessions of PDT of the lower lip at an interval of 1 week using methylaminoxopentanoate and red light. Clinical and histopathologic evaluation was performed 3 months after therapy. RESULTS

Complete clinical cure was observed in 47% (7/15) and partial cure in another 47% (7/15) of the patients. By histopathologic analysis, residual disease was found in 62% (8/13). Cosmetic results and patients' satisfaction were good to excellent in most cases. Local pain was sufficiently controlled by local anesthesia. CONCLUSION

PDT can be an effective noninvasive method to treat actinic cheilitis of the lower lip.

Metvix and BCC margins on the face

Unfortunately in the Summary we are not told the histological nature of the BCCs on the face. It is the infiltrative and morphoeic lesions we are most interested in as they are the most difficult to accurately define.IMCC

Photodetection of basal cell carcinoma using methyl 5-aminolaevulinate-induced protoporphyrin IX based on fluorescence image analysis
Authors: Won, Y.1; Hong, S. H.1; Yu, H. Y.2; Kwon, Y. H.; Yun, S. J.; Lee, S. C.; Lee, J. B.

Source: Clinical & Experimental Dermatology, Volume 32, Number 4, July 2007 , pp. 423-429(7)

Publisher: Blackwell Publishing

Abstract:

Summary Background. 

The preferential accumulation of 5-aminolaevulinic acid (ALA)-induced protoporphyrin IX (PpIX) in neoplastic cells supports its potential use in the photodetection of porphyrin fluorescence in tumour cells. Hence, epithelial tumours, including basal cell carcinoma (BCC), might be visualized using the fluorescence of selectively accumulated ALA-induced PpIX. Aim. 

In this study, we evaluated the clinical efficacy of PpIX fluorescence images using fluorescence image analysis (FIA) to define the lateral border between the tumour and tumour-free areas of facial BCC. Methods. 

FIA was used to define the lateral border between the tumour and tumour-free areas on red fluorescence images induced by the topical application of methyl 5-aminolaevulinate (MAL) ointment. According to the FIA results, 50 tissue samples, obtained from 10 patients with BCC, were divided into three categories: tumour area (n = 10), suspected tumour area (n = 20) and suspected tumour-free area (n = 20). These tissue samples were evaluated by histopathological examination. The FIA tool marked out the PpIX fluorescence image for defining the lateral border between the BCC tumour and tumour-free areas. Results. 

The rate of tumour detection from BCC lesions using PpIX fluorescence with the FIA tool showed a sensitivity of 94.1% and specificity of 82.6%. Conclusion. 

These results suggest that MAL-induced PpIX fluorescence imaging using FIA is quite sensitive and specific for detecting tumour and occult tumour in facial BCC lesions. This method of presurgical in vivo imaging is therefore proposed as a useful tool for defining the lateral border between BCC tumour and tumour-free areas