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.
Photodynamic Therapy Unit, Elisha Medical Center, Haifa, Israel.
Y
Y
Harth
B
B
Hirshowitz
B
B
Kaplan
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