Pain in photodynamic therapy: mechanism of action and management strategies.
Photodynamic therapy involves administration of a photosensitizing drug and its subsequent activation by irradiation with a light source at wavelengths matching the absorption spectrum of the photosensitizer. In many countries around the world, topical photodynamic therapy has been approved for treatment of cutaneous oncologic conditions such as actinic keratosis, Bowen's disease, and superficial basal cell carcinoma. Multicenter, randomized, controlled studies have confirmed its efficacy and superior cosmetic outcomes compared to conventional therapies. Nevertheless, this therapeutic method presents some adverse effects, such as erythema, edema, pigmentation, pustules, and pain. There is no doubt that pain is the most severe of the adverse effects, being sometimes responsible for definitive treatment interruption. The pain mechanism has not yet been fully understood, which makes complete pain control a challenge to be conquered. In spite of that, this literature review presents some useful pain management strategies as well as the most important pain-related factors in photodynamic therapy.
Department of Dermatology, School of Medicine, University of Sao Paulo, Brazil. chavesyuri@hotmail.com
Yuri Nogueira
YN
Chaves
Luis Antônio
LA
Torezan
Ane Beatriz Mautari
AB
Niwa
José Antônio
JA
Sanches Junior
Ciro
C
Festa Neto
D006801:Humans; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010778:Photochemotherapy / Q000009:adverse effects* / Q000379:methods; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012871:Skin Diseases / Q000188:drug therapy*
D017319:Photosensitizing Agents