Updated guidelines confirm high efficacy of topical PDT

Oslo, Norway, 17 December 2008.
Updated guidelines* published just recently in BJD December 2008 provide strong evidence of the high efficacy of topical PDT in actinic keratosis (AK), Bowen’s disease (BD) and superficial basal cell carcinoma (BCC). The guidelines also confirme the superiority of cosmetic outcome over standard therapy. Randomized comparison studies also support the efficacy of topical PDT, following lesion preparation, in thin nodular BCC, with recurrence rates over 5 years recently published.

The response of organ transplant recipients to PDT appears reduced compared with immunocompetent controls, but this modality may still be useful for the treatment and possible prevention of NMSC (non melanoma skin cancer) in this challenging situation. Current evidence demonstrates reductions in anticipated lesion numbers following PDT; the relative contribution of primary prevention of de-novo lesions and treatment of preclinical lesions requires further investigation.

Since the original guidelines a large number of additional applications for topical PDT have been described in the literature. It appears that efficacy as well as greater patient tolerance of PDT can be achieved in infective and inflammatory indications through lower dose, less intense treatment regimens, although multiple treatments are usually required.

During the last 5 years, considerable interest has been shown in the potential of PDT to promote photorejuvenation with observed improvements of fine lines, skin roughness and mottled hyperpigmentation. Further well-designed studies are required in this area.

The updated British guidelines have been prepared on behalf of the British Photodermatology Group and the British Association of Dermatologists (see abstract)

*C.A. Morton et al. “Guidelines for topical photodynamic therapy:update.” Br J Dermatol. 2008 Dec;159(6):1245-66.