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Background: Photodynamic therapy (PDT) is increasingly used for non-invasive destruction of basal cell skin cancer mediated by a photochemical reaction. There is no evidence-based data on its efficacy. Aim: To compare the objective response of basal cell skin cancer of various clinical types, stages, histological types, course and localization to PDT with the intralesional administration of photosensitizers Radachlorin and Fotoditazin. Materials and methods: From March 2007 to March 2010, the study recruited 74 patients with primary and relapsing solid basal skin cancer (ulcerated, 40.5% of patients, superficial, 24%, nodular, 21.5%, scleroderma-like, 14%), stage Ι–ΙI (mostly Т₂N₀M₀); with localization that was unfavorable in terms of relapses and inconvenient for treatment application. The tumors were of a uniform complex histological type and of a morphea type. The patients were administered one course of PDT with an intralesional administration of chlorine photosensitizers. The group I (n=45) was administered Radachlorin (0.5–1 mL per 1 cm² of the tumor surface), group II (n=34) was administered Fotoditazin (0.3–0.5 mL per 1 cm² of the tumor surface). For all patients the light dose was chosen at 300 J/cm², the light source being the medical laser device LAMI with a wave length of 662±3 nm, class II А. Clinical and cytological regression of the lesions at 3 months after treatment was chosen as a primary study endpoint. The secondary endpoints were a stable clinical and cytological response at 12 months after treatment. Thereafter, a relapse-free period was assessed annually up to 5 years after treatment. In addition, adverse reactions to treatment were registered up to 2 months and cosmetic results were assessed at 12 months after PDT. The treatment results were assessed in all patients. Results: Complete regression of basal cell skin cancer was found in 43 (95.5%) of patients from the group I and in 31 (91.2%) patients from the group II. Partial regression was seen in 2 (4.5%) and 3 (8.8%) of patients, respectively; these patients were subsequently cured by repeated courses of PDT. In both groups, there was no difference in the early treatment results in patients with various clinical forms of basal cell skin cancer at Т₁N₀M₀ (p>0.05). There was a significant improvement in the treatment results for the ulcer type of the tumor at stage T₂N₀M₀: 92.8% in the group I and 77.8% in the group II (р

Background: Localized scleroderma often results in irreversible cosmetic abnormalities and if advanced, to organ dysfunction and disability. Pharmacological treatment is not effective enough and can cause adverse events and complications. Due to this fact, much attention is paid to non-medical approaches to this disorder that would be able to exert positive clinical and patho-physiological effects and potentiate the effects of medical treatment. Aim: To evaluate the effects of local long-wave infrared irradiation on the course of localized scleroderma and to assess therapeutic efficacy of this method combined with conventional pharmacological treatment. Materials and methods: Fifty five (55) patients with localized scleroderma were included into the study. The patients from the control group (n = 20) were administered conventional medical treatment for 14 to 20 days, including antibacterials, proteolytic enzymes, calcium antagonists, antioxidants, topical vasculoprotectors + microcirculation correctors, as well as applications of corticosteroids. The patients from the main group (n = 35), in addition to conventional medical treatment, were administered local long-wave infrared irradiation of the lesions (wavelength 4 to 16 mcm, once daily for 10 days). We assessed changes in edema and hyperemia on the borders of the lesion, the degree and extent of the process with a modified scoring system mRODNAN Skin Score, as well as microcirculatory vasculature by means of Spectrotest. Results: Compared to the control group, the patients with localized scleroderma who, in addition to conventional medical treatment, were administered local long-wave infrared irradiation, showed a bigger reduction of mRODNAN index (2.2 ± 0.1 and 6.3 ± 0.5, respectively, р < 0.05), of oxygen saturation within the lesions (0.646 ± 0.04 and 0.9 ± 0.001 units, р < 0.05) and an increase of blood flow volume in the microcirculation (0.23 ± 0.045 and 0.091 ± 0.002 units, р < 0.05). They also demonstrated a quicker clinical improvement that was obvious at day 14 ± 2.3 (р < 0.05). In the control group, the clinical improvement was seen only at day 20 ± 4.2 (р < 0.05), with only a tendency towards a decrease in oxygen saturation within the lesions (from 0.87 ± 0.01 to 0.817 ± 0.005) and an increase of blood flow volume in the micro-circulation (from 0.086 ± 0.004 to 0.1 ± 0.003 units). The conventional medical treatment did not result in full resolution of the local scleroderma elements, this was confirmed by the results of assessment with mRODNAN index (mean value before treatment in this group was 6.4 ± 0.5, after treatment, 5.3 ± 0.2, р ≥ 0.05). Conclusion: The study proved the clinical efficacy of local long-wave infrared irradiation in the combination treatment of localized scleroderma. This effect was seen in the normalization of microcirculation parameters, increase of blood flow, decrease of oxygen saturation within the lesions reflecting active reparation, as well as in better clinical efficacy and more quick effect.

Background: Photodynamic therapy is frequently applied for non-invasive destruction of basal cell carcinomas (BCC) of the skin; though, there is lack of evidence for efficacy of the method. Aim: To assess objective response of BCCs to photodynamic therapy with intralesional administration of photosensitizer Radachlorin in patients with different clinical forms, stages, flow patterns and localization of BCC. Materials and methods: 45 stage I–II BCCs patients with primary and recurrent solitary (ulcerative, superficial, scleroderma-like and nodular forms) and multiple lesions (predominantly Т₁– Т₂N₀M₀), with difficult to treat localization and high risk of recurrence were included during the period from March 2004 to March 2007. All patients received one cycle of photodynamic therapy with intralesional Radachlorin (0.5–1 ml/1 cm² tumor surface) and irradiation dose 300 J/cm² (wavelength 662 nm). A primary outcome measure was grade of clinical and cytological lesion regression after three months. Secondary outcome measure was stable clinical and cytological reaction at the lesion site. In the long-term, lesion recurrence was assessed yearly during 5 years. Results: Complete regression of BCCs was found in 43 (95.5%) patients and 47 (95.9%) lesions. In 2 (4.5%) patients with partial regression of 2 (4.1%) lesions repeated cycles of photodynamic therapy resulted in complete response. In BCCs Т₁N₀M₀, early outcome was independent from the clinical form of the diseases; by contrast, in BCCs Т₂N₀M₀, treatment of scleroderma-like BCCs was non-significantly less effective (66.7%) compared to nodular, surface (100% for both) and ulcerative (92.8%) forms. In the long-term, 1 tumor recurrence was observed after 29 months at the site of completely regressed ulcerative lesion. Conclusion: Photodynamic therapy with intralesional administration of photosensitizer Radachlorin is an effective treatment method for different clinical forms of BCC.