Photodynamische Therapie: Nichtonkologische Indikationen

Abstract

While efficacy of photodynamic therapy (PDT) in the treatment of superficial, non-melanoma skin cancer has been proven in controlled clinical trials, there are only few controlled studies showing the usefulness of topical PDT for non-oncologic diseases of the skin. Several promising reports on PDT of inflammatory dermatoses, e. g. psoriasis vulgaris, localized scleroderma, lichen sclerosus et atrophicus or virus induced skin disorders offer promise that PDT will set up in this area also since it offers several advantages over established treatment modalities and is associated with only few side effects. In contrast to PDT of tumors, where the aim of therapy is tumor destruction, PDT of inflammatory disorders probably works by modulating cellular functions. Therapeutic protocols therefore differ markedly from those used for tumor destruction. For treatment of inflammatory dermatoses usually very low photosensitizer and light doses are sufficient (“low-dose PDT”), however multiple treatments are commonly necessary to achieve the desired effects. Most experiences are available with the endogenous topical photosensitizer 5-aminolevulinic acid. Only for the treatment of psoriasis also systemic photosensitizers have been used successfully. Controlled clinical trials are necessary to study the efficacy of PDT in this promising new field of inflammatory disorders, to establish treatment protocols and probabl y find new indications for PDT in dermatology. Originalarbeit