Modified topical photodynamic therapy of superficial skin tumors, utilizing aminolevulinic acid, penetration enhancers, red light, and hyperthermia.
BACKGROUND
Photodynamic therapy (PDT) is a noninvasive selective therapy for a specific group of skin tumors.


OBJECTIVE
In this study we used a modified topical medication in which ethyleneamine tetra acetic acid (EDTA) and dimethylsulphoxid (DMSO) were added to 5-aminolevulinic acid 20% (ALA) followed by exposure to a novel high output light source emitting red and infrared irradiation.


METHODS
ALA 20%-EDTA 2%-DMSO 2% in a water in oil cream base was applied to the tumors. After 12 hours the tumor was exposed to red (585-720 nm; 150 mW/cm2) and near infrared irradiation (1.25-1.6 mm; 50 mW/cm2) for 10-15 minutes by the VersaLight incoherent filtered light source.


RESULTS
Complete responses were achieved after one to three ALA-PDT treatments in 26/31 lesions of superficial or small nodular basal cell carcinoma (BCC) (84%), and in four of five in superficial squamous cell carcinoma (SCC) (80%). Complete clearance was achieved in one patient with Bowen's disease of the penis.


CONCLUSIONS
Topical PDT utilizing ALA 20%-EDTA 2%-DMSO 2% as the photosensitizer and VersaLight as the light source is a noninvasive, nearly painless treatment with excellent therapeutic and cosmetic results. Our data show the efficiency of this therapy for patients with certain subtypes of BCC, SCC, and Bowen's disease.
Harth
Y
Y
Photodynamic Therapy Unit, Elisha Medical Center, Haifa, Israel.
Hirshowitz
B
B
Kaplan
B
B
D000279:Administration, Cutaneous; D000368:Aged; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D001913:Bowen's Disease / Q000188:drug therapy; D002280:Basal Cell Carcinoma / Q000188:drug therapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002614:Chelating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage / Q000627:therapeutic use; D004492:Edetic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007259:Infrared Rays / Q000627:therapeutic use; D008027:Light; D008297:Male; D010412:Penile Neoplasms / Q000188:drug therapy; D010778:Photochemotherapy / Q000379:methods; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D012869:Skin Absorption; D012878:Skin Neoplasms / Q000188:drug therapy*
D002614:Chelating Agents; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; D004492:Edetic Acid; D004121:Dimethyl Sulfoxide