Photodynamic therapy with topical aminolevulinic acid

Table 1 Most common reported indications for photodynamicic therapy in oncological and non-oncological skin diseases

Oncological skin disease

Actinic keratoses

Bowen’s disease

Basal cell carcinoma

Squamous cell carcinoma

Cutaneous T-cell lymphoma

Cutaneous B-cell lymphoma

Extra-mammary paget’s disease

Non oncological skin disease

Acne vulgaris

Warts

Photorejuvenation

Other indications:

Cutaneous leishmaniasis

Localized scleroderma

Lichen sclerosus

Perioroal dermatitis

Cutaneous mycosis

Table 2 Reported results of photodynamic therapy in different skin diseases

Ref.	Disease	Remission rate	Follow up	n
Jeffes et al[24], 1997	AK	91% scalp, face 45% trunk	16 wk	40
Tschen et al[25], 2006	AK scalp, face	78%	12 mo	101
Stender et al[26], 1996	AK lip	100%	12 mo	3
Cairnduff et al[27], 1994	BD	89%	18 mo	36
López et al[29], 2012	BD	90%	12 mo	18
Truchuelo et al[30], 2012	BD	76%	17 mo	47
Calzavara-Pinton et al[31], 2008	SCC	57% microinvasive 26% nodular invasive	2 yr	55
Christensen et al[32], 2009	BCC	68% single session 91% two session	6 yr	60
Christensen et al[33], 2012	BCC	60% single session 87% two session	10 yr	60
Souza et al[34], 2009	BCC	> 90%	3 mo	34
		60%	5 yr
Soler et al[35], 2001	BCC	89%	3 yr	350
Svanberg et al[49], 1994	TCL	100%	6-14 mo	4
Orenstein et al[50], 2000	TCL	100%	24-27 mo	2
Mori et al[51], 2006	BCL	100%	8-24 mo	3
Shieh et al[52], 2002	PD	50%	6 mo	5
		31%	10 mo
Raspagliesi et al[54], 2006	PD	57%	1-5 mo	7
Stender et al[58], 2000	Hand-foot W	76%	18 wk	45
Fabbrocini et al[59], 2001	Plantar W	75%	2 mo	64
Fehr et al[63], 2002	Vulvar W	66%	12 mo	16
Stefanaki et al[64], 2003	Male genital W	73%	12 mo	12

AK: Actinic keratosis; BD: Bowen’s disease; SCC: Squamous cell carcinoma; BCC: Casal cell carcinoma; TCL: Cutaneous T-cell lymphoma; BCL: Cutaneous B-cell lymphoma; PD: Extra-mammary Paget’s disease; W: Warts.

Table 3 Strength of recommendation and the level of evidence of the different indications of photodynamic therapy[24,25]

Disease	Strength of recommendation	Quality of evidence
Actinic keratoses	A	I
Bowen’s disease	A	I
Invasive squamous cell carcinoma	D	II-iii
Superficial basal cell carcinoma	A	I
Nodular basal cell carcinoma	A	I
NMSC in organ transplant recipients	B	I
Prevention of NMSC in organ transplant recipients	B	I
Field cancerization	B	I
Cutaneous T-cell lymphoma	C	II-iii
Extra-mammary Paget’s disease	D	III
Infectious and inflammatory dermatoses acne	A	I
Hand and foot warts	B	I
Genital warts	B	I
Cutaneous leishmaniasis	B	I
Photorejuvenation	B	I

Strength of recommendations: A: There is good evidence to support the use of the procedure; B:There is fair evidence to support the use of the procedure; There is poor evidence to support the use of the procedure; C: There is fair evidence to support the rejection of the use of the procedure; D: There is good evidence to support the rejection of the use of the procedure. Quality of evidence: I: Evidence obtained from at least one properly designed, randomized control trial; II-i: Evidence obtained from well-designed control trials without randomization; II-ii: Evidence obtained from well-designed cohort or case control analytic studies preferably from more than one centre or research group; II-iii: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments could also be regarded as this type of evidence; III: Opinions of respected authorities based on clinical experience, descriptive studies or reports of expert committees; IV: Evidence inadequate, owing to problems of methodology (e.g., sample size, or length of comprehensiveness of follow-up or conflicts in evidence).