Ann Dermatol.  2013 Aug;25(3):335-339. 10.5021/ad.2013.25.3.335.

Photodynamic Therapy with Ablative Carbon Dioxide Fractional Laser for Treating Bowen Disease

Affiliations
  • 1Department of Dermatology, Ajou University School of Medicine, Suwon, Korea. maychan@ajou.ac.kr
  • 2Institute for Medical Sciences, Ajou University School of Medicine, Suwon, Korea.

Abstract

BACKGROUND
Topical photodynamic therapy (PDT) has been increasingly used to treat malignant skin tumors including the Bowen disease. However, patients could be displeased with the long incubation time required for conventional PDT.
OBJECTIVE
We evaluated the efficacy and safety of PDT with a short incubation time of ablative CO2 fractional laser pretreatment for treating Bowen disease.
METHODS
Ten patients were included. Just before applying the topical photosensitizer, all lesions were treated with ablative CO2 fractional laser, following the application of methyl aminolevulinate and irradiation with red light (Aktilite CL 128). Histological confirmation, rebiopsy, and clinical assessments were performed. Adverse events were also recorded.
RESULTS
Five of the ten (50%) lesions showed a complete response (CR) within three PDT sessions. After four treatment sessions, all lesions except one penile shaft lesion (90%) achieved clinical and histological CR or clinical CR only. The average number of treatments to CR was 3.70+/-1.70. The treatments showed favorable cosmetic outcomes and no serious adverse events.
CONCLUSION
The results suggest that pretreatment with an ablative fractional CO2 laser before PDT has similar treatment efficacy and requires a shorter photosensitizer incubation time compared with the conventional PDT method.

Keyword

Ablative carbon dioxide fractional laser; Bowen disease; Photodynamic therapy; Pretreatment

MeSH Terms

Bowen's Disease
Carbon
Carbon Dioxide
Cosmetics
Humans
Lasers, Gas
Light
Photochemotherapy
Skin
Treatment Outcome
Triazenes
Carbon
Carbon Dioxide
Cosmetics
Triazenes

Figure

  • Fig. 1 Clinical clearance of Bowen disease on right cheek with ablative CO2 fractional laser pretreatment following methyl aminolevulinate-photodynamic therapy (MAL-PDT). (A) Before treatment, (B) after treatment.

  • Fig. 2 Histological clearance of Bowen disease following pretreatment with a ablative CO2 fractional laser following methyl aminolevulinate-photodynamic therapy (MAL-PDT) (H&E, ×200). (A) Before treatment, (B) after treatment.

  • Fig. 3 Fluorescence assessment of the lesion (arrows). (A) Before application of photosensitizer, (B) after 70 minutes as incubation time.


Cited by  1 articles

Photodynamic Therapy in Bowen Disease of the First Web Space of the Hand
Soo-Eun Jung, Sue Kyung Kim, You Chan Kim
Ann Dermatol. 2015;27(1):76-78.    doi: 10.5021/ad.2015.27.1.76.


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