Daylight photodynamic therapy is an option for the treatment of actinic keratosis in patients with xeroderma pigmentosum

Daylight photodynamic therapy is an option for the treatment of actinic keratosis in patients with xeroderma pigmentosum in Africa:



Publication date: Available online 2 January 2020

Source: Photodiagnosis and Photodynamic Therapy

Author(s): M. Fernández-Guarino, D. Mavura, P. Fernández-González, P. Chapa, C. Ravazzano, L. Jaén, L. Rios, P. Jaén, H. Grossman

Abstract

Background

Xeroderma pigmentosum (XP) is a very rare and severe genetic disorder with a DNA repair defect of ultraviolet (UV)-induced damage. Photodynamic therapy (PDT) has been successfully used to treat XP and actinic keratosis (AK) and daylight PDT (DL-PDT) has demonstrated similar efficacy to conventional PDT (C-PDT).

Objectives

To assess DL-PDT for the treatment of AK in patients with XP.

Methods

Patients with XP were evaluated by a group of Spanish and African dermatologists. Clinical characteristics of the patients were assessed and divided in mild, severe or moderate affectation of AK in the face. A topical photosensitizer was extended on the patients’ faces and after two hours of indoor light exposure, fluorescence was assessed and the cream was removed. Patients were examined two and seven days later to assess the reaction to PDT and followed up three months later.

Results

A total of 13 patients were treated on the whole face. Three were classified as severe, six as moderate and four as mild. Fluorescence assessment showed a soft yellow-green colour and a pink-one delimiting the AK. Two days after treatment patients presented a scaly reaction. After one week the reaction healed, there was improvement and after three months no adverse events were noticed.

Conclusions

PDT is an option for treatment of AK in patients with XP.