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Short‐term chemical pretreatment cannot replace curettage in photodynamic therapy
Author(s) -
Nissen Christoffer V.,
Wiegell Stine Regin,
Philipsen Peter Alshede,
Wulf Hans Christian
Publication year - 2016
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12236
Subject(s) - curettage , betamethasone , protoporphyrin ix , salicylic acid , photodynamic therapy , calcipotriol , debulking , medicine , fluorescence , chemistry , surgery , dermatology , biochemistry , organic chemistry , cancer , physics , ovarian cancer , quantum mechanics , psoriasis
Summary Background Guidelines for photodynamic therapy ( PDT ) recommend pretreatment with curettage/debulking to enhance intracellular formation of protoporphyrin IX (Pp IX ). However, studies suggest that new chemical pretreatment procedures may replace curettage/debulking. Purpose To investigate how pretreatment with curettage and two combination ointments containing calcipotriol/betamethasone and salicylic acid/betamethasone affect Pp IX fluorescence after the application of methyl aminolevulinate MAL and 5‐aminolevulinic acid ( BF ‐200 ALA ). Methods Four fields on the forearms of 30 healthy volunteers were pretreated with curettage or short‐term application of calcipotriol/betamethasone or salicylic acid/betamethasone for 20 min. Two fields were not pretreated, thus serving as reference. After pretreatment, MAL or BF ‐200 ALA was applied for 24 h, and Pp IX fluorescence was measured hourly from 1 to 5 h and after 18, 21 and 24 h. Results Curettage significantly enhanced Pp IX fluorescence for MAL from 1 to 21 h ( P < 0.0041). For BF ‐200 ALA , curettage enhanced fluorescence from 1 to 5 h ( P < 0.000064), while fluorescence was lower from 18 to 24 h. Pretreatment with salicylic acid/betamethasone and calcipotriol/betamethasone before BF ‐200 ALA application did not increase Pp IX fluorescence from 1 to 5 h compared to no pretreatment, and both were significantly inferior to curettage ( P < 0.0017 and 0.0024, respectively). Conclusion Curettage significantly enhances Pp IX fluorescence from 1 to 5 h and is superior to short‐term chemical pretreatment. Our results support curettage as standard pretreatment in PDT .