Therapeutic Revolution in Dermatology
European Society for Photodynamic Therapy (Euro PDT), held in
PDT, described the current state of topical photodynamic therapy, a
revolutionary treatment for precancerous skin lesions and superficial skin
carcinomas. He also underscored the major role played by the Euro PDT, whose
objective is to promote research, development, and clinical applications of
What are PDT’s indications and advantages?
non-melanoma skin cancers. Euro-PDT’s recommendations specify that topical
PDT could be one of the treatments of choice for actinic keratoses, Bowen’s
disease, and superficial and even nodular baso-cellular skin cancers, which
are the most common skin cancers and are caused by exposure to the sun (1).
PDT avoids recourse to surgery and its scarring after effects. Hence its
advantages are obvious: this treatment allows recovery in five years in more
than 80% of cases with no visible scar; this is an essential advantage in
cosmetic terms for lesions in open areas of the skin, especially those on the
face and neckline. This represents undeniable therapeutic progress that is
also very simple to apply. This treatment is also very specific in that it
destroys only cancerous cells. It also makes it possible to treat large areas
of skin in a single session with excellent tolerance and perfect cosmetic
results, which is especially appreciated by patients.
Can several PDT sessions be applied if lesions recur?
toxicity. When lesions reappear, the patient can again be offered treatment
by PDT, and the treatment can be repeated as many times as necessary. In rare
cases of failure, all therapeutic options are available because of the
absence of local or general toxicity from PDT, with no loss of the patient’s
chances. When skin lesions are extensive, treatment by PDT makes it possible
to pinpoint the “PDT-resistant” lesions that require some other therapeutic
Are there other possible uses of PDT?
AMM; some skin lymphomas can benefit from it, with remarkable effectiveness.
PDT can also be used preventively in transplant patients, in whom skin cancer
appears in 15% of cases after the transplant.
Cosmetic use of PDT is also practiced outside AMM for its “rejuvenating”
effect. Patients presenting an actinic keratosis also benefit from this
positive secondary effect of PDT.
The relatively recent concept of “field cancerization” could become an
indication for PDT. A field cancerization around actinic keratosis lesions
forms an area with pre-neoplastic anomalies and infra-clinical and multifocal
genetic mutations that can evolve into primitive new tumours and local
recurrences. It seems logical to treat all of this area preventively rather
than to treat an isolated lesion. Applying Metvix makes it possible to more
easily see the non-visible lesions, which glow under black light. This method
is very much appreciated by patients, who can use it to see their skin risk
and easily understand the need for treatment.
With regard to the development of PDT, what are Euro PDT’s main
(Euro PDT) is a clearinghouse for practitioners and researchers; its
objective is to promote research, development and clinical applications for
photodynamic therapy in
has held an international conference to inform specialists about the results
of international research on the use of PDT in dermatology. Euro PDT also
participates in most international and national dermatology conferences. Euro
PDT holds regular training sessions in order to teach practitioners how to
properly use photodynamic therapy. This instruction with certification takes
an entire day. In particular, we stress optimal management of the pain
associated with the treatment, which the patient must be informed of. This
training has led to the creation of excellent PDT research and treatment
centers, for example at Saint Louis Hospital in
With photodynamic therapy being used worldwide, in
published international recommendations in order to define its instructions
and standardize its clinical application in treating non-melanoma skin
cancers (1). Finally, Euro PDT creates many partnerships with university
research labs, the pharmaceutical industry and clinical research teams.
(1) Braathen L, Szeimies RM, Basset-Seguin N, et coll.: Guidelines on the
use of photodynamic therapy for nonmelanoma skin cancer: An international
consensus. J AM Acad Dermatol 2007; 125-143.
10th Congress of the European Society for Photodynamic Therapy (Euro PDT)
SOURCE European Society for Photodynamic Therapy (Euro PDT)