Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy

  title={Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy},
  author={R M Szeimies and Luis Antonio Torezan and Ane Beatriz Mautari Niwa and Neusa Yuriko Sakai Valente and Petra Unger and Elisabeth Kohl and Stephan Schreml and Philipp Babilas and Sigrid Karrer and Cyro Festa-Neto},
  journal={British Journal of Dermatology},
Summary Background  The field cancerization concept in photodamaged patients suggests that the entire sun‐exposed surface of the skin has an increased risk for the development of (pre)‐malignant lesions, mainly epithelial tumours. Topical photodynamic therapy (PDT) is a noninvasive therapeutic method for multiple actinic keratosis (AK) with excellent outcome. 
Daylight photodynamic therapy vs. Conventional photodynamic therapy as skin cancer preventive treatment in patients with face and scalp cancerization: an intra‐individual comparison study
Individuals with medical history of non‐melanoma skin cancers usually develop multiple and/or recurrent malignant lesions around the site of the primary neoplasm, supporting the presence of multiple malignant clones of dysplastic keratinocytes over the entire epithelium.
Photodynamic therapy vs. imiquimod 5% cream as skin cancer preventive strategies in patients with field changes: a randomized intraindividual comparison study
Photodynamic therapy and imiquimod cream 5% are recommended as field‐directed treatment options for actinic damage in patients with recurrent non‐melanoma skin cancers.
Targeted and Personalized Therapy for Nonmelanoma Skin Cancers
AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise consideration of a diagnosis of field cancerization.
Treatment of cutaneous field cancerization
The cutaneous field cancerization corresponds to an area of skin chronically exposed to the sun. It contains actinic keratoses and other skin signs of photodamage caused by ultraviolet radiation.
Efficacy of photodynamic therapy with laser pretreatment for actinic keratosis and photorejuvenation as evaluated by fluorescent imaging
The Methylaminolevulinate‐photodynamic therapy (MAL‐PDT) has been reported to be effective in treating actinic keratosis (AK). Fluorescent images taken after topical MAL application have been used to
Photodynamic therapy in photoaging: literature review
This review addresses procedures with different light sources and photosensitizers, as well as clinical and collateral effects of this therapy in the treatment of photoaging.
Photodynamic therapy in Brazil: 10 years of history
This new method, which uses daylight, was approved in Brazil in 2014 for the treatment of actinic keratosis and field cancerization, with the benefit of maintaining c-PDT’s efficacy without adverse events.
Field cancerization: from molecular basis to selective field-directed management of actinic keratosis.
Preventive effects and a delay in the re-occurrence of NMSC have been observed in animal experiments of ingenol mebutate and PDT, whereas for the latter, clinical data are already available.
Advances in Photodynamic Therapy for the Treatment of Malignant and Premalignant Lesions in Transplant Dermatology
Clinical data for the treatment and prevention of NMSC in OTR using PDT is reviewed, including pretreatment and treatment considerations and associated risks.


Photodynamic therapy reduces the histological features of actinic damage and the expression of early oncogenic markers
Photodynamic therapy has been shown to be effective in treating nonmelanoma skin cancer, especially actinic keratosis, and in preventing the appearance of premalignant and malignant lesions in organ transplant recipients.
Skin cancer: preventive photodynamic therapy in patients with face and scalp cancerization. A randomized placebo‐controlled study
The field cancerization theory suggests that the entire epithelial surface of the regional skin has an increased risk for the development of malignant lesions around the site of the primary tumour.
Clinical and echographic analysis of photodynamic therapy using methylaminolevulinate as sensitizer in the treatment of photodamaged facial skin
The aim was to assess efficacy and tolerability of methylaminolevulinate (MAL) as a substitute for ALA in PDT treatment of actinic keratosis (AK) and photoaging.
Immunohistochemical expression of matrix metalloproteinases in photodamaged skin by photodynamic therapy
The results confirmed that PDT‐induced matrix metalloproteinase expression and collagen production have been studied in normal skin and in inflammatory disease, but there is no report about the effect of PDT on the extracellular matrix in photodamaged skin.
Aesthetic effects of topical photodynamic therapy
The available literature for photodynamic rejuvenation is reviewed while discussing cosmetic effects, light sources, adverse effects and the mechanism of action.
The clinical efficacy of topical methyl-aminolevulinate photodynamic therapy in moderate to severe actinic keratoses of the face and scalp
MAL-PDT induces a high clearance rate of AKs, dependent on the degree of field cancerization, with a good improvement in photodamage and prevention of developing new AKs.
Effect of carbon dioxide laser resurfacing on epidermal p53 immunostaining in photodamaged skin.
There was a consistent decrease in p53 immunostaining in the interfollicular epidermis lasting for at least 6 moths after CO(2) laser resurfacing of photodamaged skin.
Short incubation with methyl aminolevulinate for photodynamic therapy of actinic keratoses
A reduced incubation period for photodynamic therapy using methyl aminolevulinate is an effective first‐line treatment for actinic keratoses and may have practical advantages.