REVIEW  PDT FOR NON-MELANOMA SKIN CANCER Free access

Giornale Italiano di Dermatologia e Venereologia 2018 December;153(6):806-10

DOI: 10.23736/S0392-0488.18.06015-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Daylight photodynamic therapy for field cancerization: lessons from molecular biology

Max RYBARSKI ¹, Lutz SCHMITZ ², Ben NOVAK ¹, Thomas DIRSCHKA ^{3, 4} ✉

¹ Department of Animal Physiology, Ruhr-University, Bochum, Germany; ² Department of Dermatology, Ruhr-University, Bochum, Germany; ³ CentroDerm GmbH, Wuppertal, Germany; ⁴ Faculty of Health, University Witten-Herdecke, Witten, Germany

Actinic keratoses (AKs) represent in-situ squamous cell carcinomas that potentially invade subepidermal structures and may metastasize. Until now, it is unpredictable to determine which AK lesions show this aggressive behavior. As AKs usually occur in large sun exposed areas, field-directed treatments have become the standard treatment regimen. Among these, conventional photodynamic therapy (cPDT) with 5-aminolaevulinic acid (ALA) or methyl-aminolevulinate (MAL) using red light is particularly effective in the treatment of AKs, but acceptance of the therapy is impaired by severe pain during treatment. Daylight PDT (dPDT) has demonstrated to be an equally effective alternative treatment option which is less painful. Recent attempts to determine the risk of AKs that demonstrate particular aggressive biological behavior by implementation of clinical and histological characteristics of AKs have not lead to conclusive results. Therefore, a look at the molecular biology of AKs could serve as a useful tool to develop a risk profiling for separation of those patients that are of particular risk to develop invasive tumor and, by this, to facilitate a more effective and adapted treatment option.

KEY WORDS: Photochemotherapy - Keratosis, actinic - Biomarkers - Molecular biology