Daylight photodynamic therapy for field cancerization: lessons from molecular biology.

G Ital Dermatol Venereol

CentroDerm GmbH, Wuppertal, Germany -

Published: December 2018

AI Article Synopsis

  • Actinic keratoses (AKs) are early forms of skin cancer that can potentially become invasive, but it's currently challenging to identify which lesions might turn aggressive.
  • Traditional treatments like photodynamic therapy (cPDT) are effective but can be very painful, while an alternative called daylight PDT (dPDT) offers similar results with less discomfort.
  • Research into the molecular biology of AKs might help create a risk assessment tool to better identify patients at higher risk for more serious tumors, leading to improved treatment options.

Article Abstract

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.

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http://dx.doi.org/10.23736/S0392-0488.18.06015-7DOI Listing

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