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Photodynamic Therapy of Nonmelanoma Skin Cancer with Topical Hypericum perforatum Extract—A Pilot Study
Author(s) -
Kacerovská Denisa,
Pizinger Karel,
Majer Filip,
Šmíd František
Publication year - 2008
Publication title -
photochemistry and photobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 131
eISSN - 1751-1097
pISSN - 0031-8655
DOI - 10.1111/j.1751-1097.2007.00260.x
Subject(s) - hypericin , actinic keratosis , photodynamic therapy , dermatology , medicine , photosensitizer , skin cancer , hypericum perforatum , bowen's disease , basal cell carcinoma , keratosis , cancer , basal cell , pathology , pharmacology , chemistry , photochemistry , organic chemistry
Hypericin, the photoactive compound of Hypericum perforatum , is probably the most powerful photosensitizer found in nature. This compound has shown high potency in the photodynamic treatment of tumor cells. However, there is only limited knowledge regarding the photodynamic effect of hypericin on nonmelanoma skin cancer cells. The aim of this prospective study was to investigate the efficacy of photodynamic therapy with topical application of an extract of H. perforatum in actinic keratosis, basal cell carcinoma (BCC) and morbus Bowen (carcinoma in situ ). The study was carried out on 34 patients—eight with actinic keratoses (AKs), 21 with BCC and five with Bowen’s disease. The extract of H. perforatum was applied on the skin lesions under occlusion and that was followed by irradiation with 75 J cm −2 of red light 2 h later. The treatment was performed weekly for 6 weeks on average. The percentage of complete clinical response was 50% for AKs, 28% in patients with superficial BCC and 40% in patients with Bowen’s disease. There was only a partial remission seen in patients with nodular BCCs. A complete disappearance of tumor cells was found in the histologic preparation of 11% of patients with superficial BCCs and 80% in the patients with Bowen’s disease. All patients complained of burning and pain sensations during irradiation. Although the results of this first clinical trial could be regarded as disappointing, there are still possibilities for improvement. Better preparation of the lesions, enhancement of hypericin delivery and other types of light exposure procedures could significantly improve the clinical outcomes of this relatively inexpensive treatment modality.